Twin-to-twin transfusion syndrome (TTTS) is a serious complication for both fetuses occurring in 10—15% of monochorionic multiple pregnancies with various placental complications, including hypoxia, anemia, increased oxidative stress, and ischemia-reperfusion injury. Being minimally invasive surgical procedure fetoscopic laser coagulation of vascular anastomoses is the treatment of choice dramatically improves the survival rates in twin-to-twin transfusion syndrome.
OBJECTIVE
To study the frequency and structure of complications of fetoscopic laser coagulation of placental anastomoses in TTTS.
MATERIAL AND METHODS
A retrospective study of 258 monochorionic pregnancies complicated by TTTS which underwent laser coagulation of placental anastomoses in 2013—2021 years.
RESULTS
Fetoscopic laser coagulation of anastomoses (FLC) has complications that occur during the surgery or postoperative period. The rate of pregnancy loss after FLC is 8.5%. The overall survival rate directly correlates with the stage of FLC. The Solomon technique supports to reduce the recurrence of TTTS (9.5%), postoperative TAPS (twin anemia polycythemia sequence), the incidence of which was 2.3%.
CONCLUSIONS
Laser coagulation of placental vascular anastomoses improves perinatal outcomes in monochorionic twin pregnancies. The postoperative complications does not depend of stage twin to twin transfusion syndrome, the technical comlexity of anastomosis visualization and volume of amnioreduction. Coagulation of vascular anastomoses of the placenta through the shell of the donor fetus increases the risk of dissection of the fetal membranes and premature discharge of amniotic fluid.