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Perinatal survival in cases of twin–twin transfusion syndrome complicated by selective intrauterine growth restriction.

Authors :
Van Winden, Kristi R.
Quintero, Rubén A.
Kontopoulos, Eftichia V.
Korst, Lisa M.
Llanes, Arlyn
Chmait, Ramen H.
Source :
Journal of Maternal-Fetal & Neonatal Medicine. Sep2015, Vol. 28 Issue 13, p1549-1553. 5p.
Publication Year :
2015

Abstract

Objective: To evaluate the impact of selective intrauterine growth restriction (SIUGR) on monochorionic multiples treated with selective laser photocoagulation of communicating vessels (SLPCVs) for twin-twin transfusion syndrome (TTTS). Methods: Perinatal survival was compared among TTTS patients with and without SIUGR. The TTTS + SIUGR group was defined as TTTS patients with donor twin weight <10th percentile. Multivariable logistic regression analyses identified factors associated with 30-day survival. Results: Of 369 patients, 65% (N = 241) had TTTS + SIUGR. Thirty-day donor twin survival for the TTTS-only group was 84% versus 75% in the TTTS + SIUGR group (p = 0.0348). Stage III donor involved (stage III donor, donor/recipient) TTTS + SIUGR patients (N = 110) had 66% 30-day donor survival. Multivariable logistic regression demonstrated that the TTTS-only group was twice as likely to achieve donor survival compared to the TTTS + SIUGR group (OR 2.01, 95% CI 1.11–3.66,p = 0.0214). In the TTTS + SIUGR group, patients not classified as stage III donor-involved were twice as likely to achieve donor survival as stage III donor-involved patients (OR 2.02, 95% CI 1.10–3.71,p = 0.0226). Conclusions: SIUGR, present in two-thirds of TTTS patients, was a risk factor for decreased donor survival. Patients with donor SIUGR and umbilical artery persistent or reversed end-diastolic flow (Quintero Stage III Donor-involved) were especially at risk. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
14767058
Volume :
28
Issue :
13
Database :
Academic Search Index
Journal :
Journal of Maternal-Fetal & Neonatal Medicine
Publication Type :
Academic Journal
Accession number :
109228405
Full Text :
https://doi.org/10.3109/14767058.2014.960834