Jun Murotsuki

Publications (2)4.21 Total impact

• Article: Ultrasound prognostic factors after laser surgery for twin-twin transfusion syndrome to predict survival at 6 months.

  Keisuke Ishii, Mari Saito, Masahiko Nakata, Yuichiro Takahashi, Satoshi Hayashi, Takeshi Murakoshi, Jun Murotsuki, Hiroshi Kawamoto, Haruhiko Sago
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  ABSTRACT: To evaluate the significance of ultrasound findings, detected one or two weeks after laser surgery for twin-twin transfusion syndrome, in predicting the mortality at 6 months of age. Ultrasound evaluation including fetal biometry, amniotic fluid volume estimation and Doppler examination was performed between 7 and 14 days after surgery for 181 cases. The presence of one or more effusions and single fetal death were also determined. Associations between ultrasound findings and mortality at 6 months of age were evaluated using multiple logistic regression analysis. Of the total 181 pairs, 145 (80.1%) donor and 160 (88.1%) recipient twins survived in utero for more than 7 days after surgery, and hence were included in the analysis. The survival rate at 6 months was 66.9% for the donor and 80.7% for the recipient twins. Risk factors for death in the donor were the presence of severe intrauterine growth restriction and effusions. In recipients, elevation in the middle cerebral artery peak systolic velocity coincided with fetal death, but this occurred in only three cases. Ultrasound risk factors one week after surgery included severe intrauterine growth restrictions and effusions in the donor twins.
  Prenatal Diagnosis 09/2011; 31(11):1097-100. · 2.11 Impact Factor
• Article: The outcome and prognostic factors of twin-twin transfusion syndrome following fetoscopic laser surgery.

  Haruhiko Sago, Satoshi Hayashi, Mari Saito, Hiromi Hasegawa, Hiroshi Kawamoto, Naomi Kato, Yukiko Nanba, Yushi Ito, Yuichiro Takahashi, Jun Murotsuki, Masahiko Nakata, Keisuke Ishii, Takeshi Murakoshi
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  ABSTRACT: To evaluate the outcome and preoperative risks of twin-twin transfusion syndrome (TTTS) following fetoscopic laser surgery (FLS). A retrospective cohort study of a series of 181 consecutive cases of TTTS before 26 weeks' gestation subjected to FLS at four centers in Japan between July 2002 and December 2006. The chances of survival of at least one twin at 28 days of age and 6 months of age were 91.2% and 90.1%, respectively. The rate of major neurological complications in survivors at 6 months of age was 4.7%. Preoperative findings that were significant risk factors for death were as follows: (1) being donor [odds ratio (OR): 3.01, 95% confidence interval (CI): 1.24-7.31, P = 0.015]; (2) reversed (OR: 11.78, CI: 3.05-45.55, P < 0.001) and absent (OR: 3.95, CI: 1.66-9.43, P = 0.002) end-diastolic velocity in the umbilical artery (EDV-UA) of the donor; and (3) reversed blood flow in the ductus venosus of the recipient (OR: 2.35, CI: 1.04-5.29, P = 0.040). FLS leads to high survival rates and low neurological morbidity for fetuses in TTTS. FLS is an effective therapeutic option for TTTS before 26 weeks of gestation. Preoperative Doppler findings of the umbilical artery and the ductus venosus are useful in predicting prognosis following FLS.
  Prenatal Diagnosis 11/2010; 30(12-13):1185-91. · 2.11 Impact Factor