Outcomes in a cohort of patients with stage I twin-to-twin transfusion syndrome

Objective To determine pregnancy outcomes of patientswho present with Stage I twin-to-twin transfusionsyndrome (TTTS). Methods This was a retrospective review of all patientswith TTTS referred to our institution between January 2005 and December 2006. Quintero criteria were usedfor staging. Laser ablation was not offered to patientswith Stage I disease. Results A total of 155 twin pregnancies were evaluatedfor TTTS during this period. Forty-two met the criteriafor Stage I and were included in the analysis. The overallsurvival to discharge was 82%. The mean gestationalage at the time of consultation was 20.9 ± 0.4 weeks.A total of 23 cases (54.8%) underwent amnioreduction. Progression of TTTS requiring invasive therapy occurredin four cases. The mean gestational age at delivery was32.5 ± 0.62 weeks. When divided according to use ofamnioreduction, there were no statistically significant differencesbetween the groups for gestational age at deliveryor for birth weight. Those Stage I cases with a CHOP cardiovascularscore of 5 or higher delivered almost 3 weeksearlier than the remainder of the cohort. Conclusions Progression of TTTS beyond Stage Ioccurred in only 9.5% of the cohort. Mean gestational ageat delivery and survival to discharge did not differ betweenStage I patients and those treated with placental laserablation for more advanced stages of TTTS.