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Gladkova K.A.

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Sakalo V.A.

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Frolova E.R.

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Kostyukov K.V.

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Khodzhaeva Z.S.

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Complications of fetoscopic laser coagulation of placental anastomosis in twin-to-twin transfusion syndrome

Authors:

Gladkova K.A., Sakalo V.A., Frolova E.R., Kostyukov K.V., Khodzhaeva Z.S.

More about the authors

Journal: Russian Journal of Human Reproduction. 2024;30(5): 55‑63

DOI: 10.17116/repro20243005155

Views: 1308

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Table of contents

COMPLICATIONS OF FETOSCOPIC LASER COAGULATION OF PLACENTAL ANASTOMOSIS IN TWIN-TO-TWIN TRANSFUSION SYNDROME
COMPLICATIONS OF FETOSCOPIC LASER COAGULATION OF PLACENTAL ANASTOMOSIS IN TWIN-TO-TWIN TRANSFUSION SYNDROME

To cite this article:

Gladkova KA, Sakalo VA, Frolova ER, Kostyukov KV, Khodzhaeva ZS. Complications of fetoscopic laser coagulation of placental anastomosis in twin-to-twin transfusion syndrome. Russian Journal of Human Reproduction. 2024;30(5):55‑63. (In Russ.)
https://doi.org/10.17116/repro20243005155

Подписка 2025-2 (Russian Journal of Human Reproduction)
 
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Recommended articles:
Feto-fetal transfusion syndrome. Anemia-polycythemia syndrome. Diagnostic methods. Treatment options. Russian Bulletin of Obstetrician-Gynecologist. 2024;(4):35-41

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.

Keywords:

twin to twin transfusion syndrome
complications twin pregnancy
monochorionic twin pregnancy
fetoscopic laser coagulation
fetal medicine

Authors:

Gladkova K.A.

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Sakalo V.A.

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Frolova E.R.

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Kostyukov K.V.

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Khodzhaeva Z.S.

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Received:

15.09.2023

Accepted:

06.10.2023

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