North American Fetal Therapy Network: Intervention vs expectant management for stage I twin-twin transfusion syndrome

Stephen P. Emery, Steve K. Hasley, Janet M. Catov, Russell S. Miller, Anita J. Moon-Grady, Ahmet Baschat, Anthony Johnson, Foong Yen Lim, Alain L. Gagnon, Richard W. O'Shaughnessy, Tulin Ozcan, Francois I. Luks

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Stage I twin-twin transfusion syndrome presents a management dilemma. Intervention may lead to procedure-related complications while expectant management risks deterioration. Insufficient data exist to inform decision-making. Objective: The aim of this retrospective observational study was to describe the natural history of stage I twin-twin transfusion syndrome, to assess for predictors of disease behavior, and to compare pregnancy outcomes after intervention at stage I vs expectant management. Study Design: Ten North American Fetal Therapy Network centers submitted well-documented cases of stage I twin-twin transfusion syndrome for analysis. Cases were retrospectively divided into 3 management strategies: those managed expectantly, those who underwent amnioreduction at stage I, and those who underwent laser therapy at stage I. Outcomes were categorized as no survivors, 1 survivor, 2 survivors, or at least 1 survivor to live birth, and good (twin live birth ≥30.0 weeks), mixed (single fetal demise or delivery between 26.0-29.9 weeks), and poor (double fetal demise or delivery

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
DOIs
StateAccepted/In press - Dec 12 2015
Externally publishedYes

Keywords

  • Expectant management
  • Natural history
  • Quintero stage I
  • Treatment
  • Twin-twin transfusion syndrome

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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