Results of laser therapy in twin-to-twin transfusion syndrome: our experience

Abstract

Objective: The authors of this paper present the results of laser treatment in twin-to-twin transfusion syndrome. Methods: Laser photocoagulation of communicating vessels was performed on 91 patients from April 2005 to June 2010, at the Medical University of Gdansk (Poland). Results of treatment were analyzed. Results: The following results were achieved: at least one survival at delivery in 71 patients (83.5%), two survivors in 49 women (57.6%), and an overall survival rate of 70.6%. After the inclusion of neonatal deaths, at least one survival was reported in 65 women (76.5%) – 30 with two survivors (44.7%) and 27 with one survivor (31.8%). The incidence of preterm rupture of membranes (4 cases – 4.3%), dual intrauterine fetal demise (7 cases – 7.4%) and miscarriage or delivery (8 cases – 8.5%) during the first week after surgery were the main reasons of pregnancy loss in the analyzed group. The frequency of cerebral palsy diagnosed after 6 months was 7%. Conclusions: Despite a lower incidence of dual neonatal survivals than in other series, the results of the first years of experience with laser treatment of twin-twin transfusion syndrome are encouraging, and prompt us to improve our surgical skills to achieve better outcomes.