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Persistent elevation of cell-free fetal DNA levels in maternal plasma after selective laser coagulation of chorionic plate anastomoses in severe midgestational twin-twin transfusion syndrome
- Source :
- American journal of obstetrics and gynecology. 192(2)
- Publication Year :
- 2005
-
Abstract
- Objective This study was undertaken to determine whether laser thermocoagulation for twin-twin transfusion syndrome (TTTS) causes increased cell-free fetal DNA levels in maternal plasma, potentially as a result of placental injury. Study design We enrolled 34 patients with twin pregnancies complicated by severe TTTS who underwent fetoscopic selective laser ablation of placental vascular anastomoses. Blood samples were drawn before and sequentially after the procedure. Fetal DNA in maternal plasma was quantified by polymerase chain reaction amplification of a Y-chromosome sequence. Results Compared with baseline, median elevations of fetal DNA levels were 0.8% at 30 minutes ( P =.32), 15.8% at 60 minutes ( P =.1), 179.5% at 24 hours ( P =.003), and 172.9% at 48 hours ( P =.003). Factors associated with increased fetal DNA levels at 24 hours after procedure included longer operation time, higher number of vessels ablated, and subsequent in utero fetal death ( P =.01, .04, and .04, respectively). Conclusions Persistent elevation of fetal DNA levels in maternal plasma after laser ablation suggests that circulating fetal DNA could derive from placental injury. Plasma fetal DNA analysis may be an additional prognostic marker for fetal outcome after laser therapy.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Placenta
Andrology
Fetus
Fetal membrane
Pregnancy
Internal medicine
Blood plasma
medicine
Humans
Laser Coagulation
business.industry
Obstetrics and Gynecology
DNA
Fetofetal Transfusion
medicine.disease
Endocrinology
medicine.anatomical_structure
Cell-free fetal DNA
In utero
Female
business
Laser coagulation
Subjects
Details
- ISSN :
- 00029378
- Volume :
- 192
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- American journal of obstetrics and gynecology
- Accession number :
- edsair.doi.dedup.....bbc50711098e06fb42e5b1608f24227a