Ultrasound Assessment prior to Laser Photocoagulation for Twin-Twin Transfusion Syndrome for Predicting Intrauterine Fetal Demise after Surgery in Japanese PatientsIshii K. · Hayashi S. · Nakata M. · Murakoshi T. · Sago H. · Tanaka K.
aDepartment of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, bDivision of Fetal Medicine, National Center for Child Health and Development, Tokyo, cPerinatal Care Center, Yamaguchi University Hospital, Ube, dMaternal and Perinatal Care Center, Seirei Hamamatsu General Hospital, Hamamatsu, and eJapan Fetoscopy Group, Tokyo, Japan
Objective: To evaluate the use of ultrasound before selective laser photocoagulation of communicating vessels (SLPCV) for twin–twin transfusion syndrome in predicting intrauterine fetal demise (IUFD). Methods: Fifty-five patients underwent SLPCV in Japan. Fetal biometry and Doppler studies of the umbilical artery, ductus venosus, and umbilical vein were performed prior to SLPCV. The visualization of the bladder and hydrops was recorded. Association between the parameters and IUFD was analyzed using multiple logistic regression analysis. The study was approved by the Institutional Review Board and patients gave their informed consent. Results: The IUFD incidence was 25.5% (14/55) in the donors and 12.7% (7/55) in the recipients. Twelve donors and 4 recipients of them ended in unexplainable IUFD. In the analysis of 53 donors, absent or reversed end-diastolic flow of umbilical artery (UAAREDF) was only associated with IUFD (p = 0.016). No parameters could predict IUFD in 52 recipients. Conclusions: UAAREDF may be useful for predicting IUFD of the donor after SLPCV.
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