ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Efficiency Assessment of Fetoscope Laser Coagulation of Placental Anastomosis in Women Pregnant with Monochorionic Diamniotic Twins

DOI:10.31550/1727-2378-2021-20-1-33-37
For citation: Bashmakova N.V., Aitov A.E., Kosovtsova N.V., Chistyakova G.N., Remizova I.I. Efficiency Assessment of Fetoscope Laser Coagulation of Placental Anastomosis in Women Pregnant with Monochorionic Diamniotic Twins. Doctor.Ru. 2021; 20(1): 33–37. (in Russian). DOI: 10.31550/1727-2378-2021-20-1-33-37
12 March 18:32

Study Objective: To assess the efficiency of fetoscope laser coagulation of placental anastomosis in women pregnant with monochorionic diamniotic twins complicated with fetofetal transfusion syndrome (FFTS).

Study Design: full controlled prospective cohort study.

Materials and Methods. We examined 95 women pregnant with monochorionic diamniotic twins. Group 1 included 45 patients who had FFTS (TOPS) and anaemia-polycythemia syndrome (TAPS) in second trimester of pregnancy; group 2 (controls) included 50 women with no ultrasound signs of FFTS. Fetoscope laser coagulation of placental anastomosis was performed in stage II-IV FFTS on weeks 16-24 of pregnancy.

Study Results. The mean delivery time in patients with FFTS after fetoscope laser coagulation of placental anastomosis was 31.9 ± 3.6 weeks. Physiological delivery in women with FFTS was recorded in 28.8% of cases vs. 8% in controls. In group 1, 48.8% of women had both foetuses alive with favourable pregnancy outcome; in 26.7% of pregnancies only one foetus survived. In stage III FFTS, pregnancy failure was observed in 7 (15.6%) patients vs. 1 (2.2%) patient with stage II FFTS (p < 0.001).

Conclusion. Pregnancy outcome and post-surgery complications depend on FFTS type and severity. Fetoscope laser coagulation of placental anastomosis makes it possible to prolong pregnancy for 13 weeks (mean value) and contributes to increased overall foetal survival to 75.5%.

Contributions: Bashmakova, N.V. — study design, review of critically important material, approval of the manuscript for publication; Aitov, A.E. — selection, examination and management of patients, thematic publications reviewing, manuscript preparation; Kosovtsova, N.V. — study design, selection, examination and management of patients, thematic publications reviewing; Chistyakova, G.N. — collection of clinical materials, data review, analysis and interpretation, manuscript preparation; Remizova, I.I. — statistical data processing, manuscript preparation.

Conflict of interest: The authors declare that they do not have any conflict of interests.

N.V. Bashmakova — Ural Scientific and Research Institute of Mother and Child Protection of the Ministry of Health of the Russian Federation; 1 Repin St., Ekaterinburg Russian Federation 620028. https://orcid.org/0000-0002-8091-9863. E-mail: bashmakovanv@niiomm.ru

A.E. Aitov (Corresponding author) — Ural Scientific and Research Institute of Mother and Child Protection of the Ministry of Health of the Russian Federation; 1 Repin St., Ekaterinburg Russian Federation 620028. E-mail: tlsbadb@mail.ru

N.V. Kosovtsova — Ural Scientific and Research Institute of Mother and Child Protection of the Ministry of Health of the Russian Federation; 1 Repin St., Ekaterinburg Russian Federation 620028. https://orcid.org/0000-0002-4670-798X. E-mail: kosovcovan@mail.ru

G.N. Chistyakova — Ural Scientific and Research Institute of Mother and Child Protection of the Ministry of Health of the Russian Federation; 1 Repin St., Ekaterinburg Russian Federation 620028. Е-mail: 7@niiomm.ru

I.I. Remizova — Ural Scientific and Research Institute of Mother and Child Protection of the Ministry of Health of the Russian Federation; 1 Repin St., Ekaterinburg Russian Federation 620028. E-mail: remizovaii@yandex.ru

Доктор.ру

Table 1
Number of anastomoses and fetofetal transfusion syndrome (FFTS) stages

t6_1.jpg

Table 2
Pregnancy outcomes after fetoscopy and laser coagulation of placental anastomosis in fetofetal transfusion syndrome (FFTS), n (%)

t6_2.jpg

Received: 19.01.2021
Accepted: 19.02.2021

12 March 18:32
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