North American Fetal Therapy Network (NAFTNet). Preoperative predictors of death in twin-to-twin transfusion syndrome treated with laser ablation of placental anastomoses

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Weill Cornell College of Medicine, New York, NY, USA.
American journal of obstetrics and gynecology (Impact Factor: 4.7). 10/2010; 203(4):388.e1-388.e11. DOI: 10.1016/j.ajog.2010.06.018
Source: PubMed


To determine preoperative predictive factors for donor and recipient death after laser ablation of placental vessels in twin-to-twin transfusion syndrome.
Retrospective analysis of North American Fetal Therapy Network center laser procedures, 2002-2009. Factors associated with donor and recipient death were identified by regression analysis.
There were 466 patients from 8 centers. Factors significantly associated with donor fetal death were low donor estimated fetal weight (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.55-0.87) and reversed end diastolic velocity in the umbilical artery (OR, 4.0; 95% CI, 1.54-10.2); for recipient fetal death-low recipient estimated fetal weight (OR, 0.65; 95% CI, 0.44-0.95), recipient reversed "a" wave in the ductus venosus (OR, 2.39; 95% CI, 1.27-4.51) and hydrops (OR, 3.7; 95% CI, 1.1-12.7); for recipient neonatal death-low donor estimated fetal weight (OR, 0.54; 95% CI, 0.30-0.95), high recipient estimated fetal weight (OR, 1.55; 95% CI, 1.06-2.26) and recipient reversed end diastolic velocity in the umbilical artery (OR, 7.8; 95% CI, 1.03-59.3).
Preoperative findings predict fetal and neonatal demise in twin-to-twin transfusion syndrome treated with laser therapy.

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