Increased risk of placental abruption after solomon laser treatment of twin-twin transfusion syndrome |
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| Institution: | 1. Fetal Therapy Unit “ U.Nicolini”, Vittore Buzzi Children''s Hospital, Università degli Studi di Milano, Milan, Italy;2. Epidemiology Unit, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milan, Italy;1. Department of Woman & Child, University Hospital Leuven, Katholieke Universiteit Leuven, B-3000 Leuven, Belgium;2. Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark;1. Obstetrics, Nutrition and Endocrinology Group, Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia;2. Mercy Perinatal Research Centre, Mercy Hospital for Women, Victoria, Australia;1. Department of Obstetrics and Gynaecology, Spaarne Gasthuis, Spaarnepoort 1, 2134 TM, Hoofddorp, The Netherlands;2. Department of Clinical Pathology, Spaarne Gasthuis, Spaarnepoort 1, 2134 TM, Hoofddorp, The Netherlands;3. Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC: University Medical Centre Rotterdam, ''s-Gravendijkwal 230, 3015 CE, The Netherlands;1. Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia;2. Department of Molecular and Translational Medicine, Monash University, Clayton, VIC, Australia;3. Centre for Cancer Research, Hudson Institute of Medical Research, Clayton, VIC, Australia;4. Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia;1. Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States;2. Department of Biomedical Sciences, Cornell University, Ithaca, NY, United States;1. Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan;2. Department of Pharmaceutics, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan;3. Faculty of Pharmaceutical Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-machi, Kanazawa 920-1192, Japan;4. Division of Membrane Transport and Drug Targeting, Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aoba Aramaki, Aoba-ku, Sendai, Miyagi 980-8578, Japan |
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| Abstract: | To evaluate the relative risk of placental abruption in monochorionic (MC) twin pregnancies complicated with twin-to-twin transfusion syndrome (TTTS) and treated with endoscopic laser coagulation of placental vessels (ELCPV).A retrospective analysis from January 2004 and December 2015 of 373 TTTS pregnancies, treated with selective ELCPV until January 2012 (287 cases), after which the Solomon technique was introduced (86 cases), compared with 243 normal MC pregnancies.A significant improvement in perinatal survival was observed after the introduction of the Solomon technique when compared to the selective procedure (77% vs 54%, p < 0.001).The rate of placental abruption was 1% (3/243) in normal MC pregnancies, 6% (21/373) in TTTS group, increased with Solomon technique (12/86, 14%, vs 9/287, 3%, p < 0.001).MC twin pregnancies treated with laser coagulation of placental vascular anastomoses could be at increased risk of placental abruption, especially when the Solomon technique is used. |
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