EXPERIENCE WITH INVASIVE CORRECTION OF FETOFETAL TRANSFUSION SYNDROME


Дәйексөз келтіру

Толық мәтін

Ашық рұқсат Ашық рұқсат
Рұқсат жабық Рұқсат берілді
Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

Objective. To analyze the authors’ data on the surgical correction of fetofetal transfusion syndrome (FFTS). Subject and methods. Over 2 years, the authors performed a total of 42 operations to correct FFTS: 16 (38%) septotomies, 10 (24%) laser coagulations of umbilical cord vessels, and 16 (38%) laser coagulations of placental anastomoses in Quintero Stages III-IV FFTS. Results. In 2011, sixteen fetoscopic septotomies were carried out at 22-26 weeks’ gestation in Quintero Stages III-IV FFTS. Pregnancy could be prolonged by an average of 5.5 weeks (from 3 to 11 weeks). All births were premature; the pregnancy length averaged 31 weeks (27-34 weeks). Manipulation complications were 40%. The efficiency was 60%. In 2012, intrauterine correction of Quintero Stages III-IV FFTS in 16 patients by total coagulation of placental anastomoses resulted in the birth and survival of 14 babies, including 4 (40%) twins. After coagulation there was one (60%) fetus in 6 cases and a donor in all cases. Complications were 37%. All the births were premature at 27-39 weeks (33 weeks). In 2011-2012, ten sessions of laser umbilical cord vessel coagulation were made in Quintero Stages III-IV FFTS. Survival of one of the twins was noted in 8 (80%) cases. Conclusion. According to our data, laser coagulation of placental anastomoses is the best decision to choose a FFTS treatment option.

Толық мәтін

Рұқсат жабық

Авторлар туралы

N. KOSOVTSOVA

Ural Research Institute of Maternal and Infancy Care, Ministry of Health of the Russian Federation

Email: kosovcovan@mail.ru
Yekaterinburg

N. BASHMAKOVA

Ural Research Institute of Maternal and Infancy Care, Ministry of Health of the Russian Federation

Yekaterinburg

V. KOVALEV

Ural Research Institute of Maternal and Infancy Care, Ministry of Health of the Russian Federation

Yekaterinburg

T. MARKOVA

Ural Research Institute of Maternal and Infancy Care, Ministry of Health of the Russian Federation

Yekaterinburg

N. POTAPOV

Ural Research Institute of Maternal and Infancy Care, Ministry of Health of the Russian Federation

Yekaterinburg

Әдебиет тізімі

  1. Sebire N.J., Snijders R.J.M., Hughes K., Sepulveda W., Nicolaides K.H. The hidden mortality of monochorionic twin pregnancies. Br. J. Obstet. Gynaecol. 1997; 104: 1203—7.
  2. Senat M.V., Bernard J.P., Loizeau S., Ville Y. Management of single fetal death in twin-to-twin transfusion syndrome: a role for fetal blood sampling. Ultrasound Obstet. Gynecol. 2002; 20(4): 360—3.
  3. Quintero R.A., Comas C., Bornick P. W., Allen M.H., Kruger M. Selective versus non-selective laser photocoagulation of placental vessels in twin-to-twin transfusion syndrome. Ultrasound Obstet. Gynecol. 2000; 16(3): 230—6.
  4. De Lia J.E., Kuhlmann R.S., Harstad T.W., Cruikshank D.P. Fetoscopic laser ablation of placental vessels in severe previable twin-twin transfusion syndrome. Am. J. Obstet. Gynecol. 1995; 172(4,Pt1): 1202—8; discussion 1208—11.
  5. Hecher K., Diehl W., Zikulnig L., Vetter M., Hackelöer B.J. Endoscopic laser coagulation of placental anastomoses in 200 pregnancies with severe mid-trimester twin-to-twin transfusion syndrome. Eur. J. Obstet. Gynecol. Reprod. Biol. 2000; 92(1): 135—9.
  6. Urig M.A., Clewell W.H., Elliot J.P. Twin-twin transfusion syndrome. Am. J. Obstet. Gynecol. 1990; 163: 1522—6.
  7. Saunders N.J., Snijders R.J.M., Nicolaides K.H. Therapeutic amniocentesis in twin-twin transfusion syndrome appearing in the second trimester of pregnancy. Am. J. Obstet. Gynecol. 1991; 166(3): 820—4.
  8. Umur A., van Gemert M.J.C., Ross M.G. Fetal urine and amniotic fluid in monochorionic twins with twin-twin transfusion syndrome: simulations of therapy. Am. J. Obstet. Gynecol. 2001; 185: 996—1003.
  9. Цывьян П.Б., Маркова Т.В., Михайлова С.В. Ультразвуковая диагностика артериальной гипертензии плода при синдроме задержки развития. Ультразвуковая и функциональная диагностика. 2006; 3: 88—9.
  10. Маркова Т.В. Оптимизация тактики ведения беременности и родоразрешения при развитии синдрома фетофетальной трансфузии у близнецов: Автореф. дис.. канд. мед. наук. СПб.; 2004. 26с.
  11. Berghella V., Kaufmann M. Natural history of twin-twin transfusion syndrome. J. Reprod. Med. 2001; 46(5): 480—4.
  12. Cook T.L., Shaugnessy R. Iatrogenic creation ofa monoamniotic twin gestation in severe twin-to-twin transfusion syndrome. J. Ultrasound Med. 1997; 16: 853—5.
  13. Ville Y., Hecher K., Gagnon A., Sebire N., Hyett J., Nicolaides K. Endoscopic laser coagulation in the management of severe twin-to-twin transfusion syndrome. Br. J. Obstet. Gynaecol. 1998; 105(4): 446—53.
  14. Yamamoto M., El Murr L., Robyr R., Leleu F., Takahashi Y., Ville Y. Incidence and impact of perioperative complications in 175 fetoscopy-guided laser coagulation of chorionic plate anastomoses in fetofetal transfusion syndrome before 26 weeks of gestation. Am. J. Obstet. Gynecol. 2005; 193(3,Pt 2): 1110—6.
  15. Robyr R., Boulvain M., Lewi L., Huber A., Hecher K., Deprest J., Ville Y. Cervical length as a prognostic factor for preterm delivery in twin-to-twin transfusion syndrome treated by fetoscopic laser coagulation of chorionic plate anastomoses. Ultrasound Obstet. Gynecol. 2005; 25(1): 37—41.
  16. Van Heteren C.F., Nijhuis J.G., Semmekrot B.A., Mulders L.G., van den Berg P.P. Risk for surviving twin after fetal death of co-twin in twin-twin transfusion syndrome. Obstet. Gynecol. 1998; 92(2): 215—9.
  17. Gratacós E., Van Schoubroeck D., Carreras E., Devlieger R., Roma E., Cabero L., Deprest J. Impact of laser coagulation in severe twin-twin transfusion syndrome on fetal Doppler indices and venous blood flow volume. Ultrasound Obstet. Gynecol. 2002; 20(2): 125—30.
  18. De Lia J.E., Kuhlmann R.S., Lopez K.P. Treating previable twin-twin transfusion syndrome with fetoscopic laser surgery: outcomes following the learning curve. J. Perinat. Med. 1999; 27(1): 61—7.
  19. Cavicchioni O., Yamamoto M., Robyr R., Ville Y. Prognosis of the surviving co-twin after intrauterine fetal demise in TTTS treated by laser. Am. J. Obstet. Gynecol. 2004; 191(6,Suppl.): S160 (563).

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