Preoperative predictors of death in twin-to-twin transfusion syndrome treated with laser ablation of placental anastomoses

Daniel W. Skupski, Francois I. Luks, Martin Walker, Ramesha Papanna, Michael Bebbington, Greg Ryan, Richard O'Shaughnessy, Julie Moldenhauer, Ozan Bahtiyar

Research output: Contribution to journalArticle

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Abstract

Objective: To determine preoperative predictive factors for donor and recipient death after laser ablation of placental vessels in twin-to-twin transfusion syndrome. Study Design: 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. Results: 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 deathlow 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 deathlow 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). Conclusion: Preoperative findings predict fetal and neonatal demise in twin-to-twin transfusion syndrome treated with laser therapy.

Original languageEnglish
Pages (from-to)388.e1-388.e11
JournalAmerican journal of obstetrics and gynecology
Volume203
Issue number4
DOIs
StatePublished - Oct 2010
Externally publishedYes

Keywords

  • laser therapy
  • stepwise logistic regression
  • twin-twin transfusion

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    Skupski, D. W., Luks, F. I., Walker, M., Papanna, R., Bebbington, M., Ryan, G., O'Shaughnessy, R., Moldenhauer, J., & Bahtiyar, O. (2010). Preoperative predictors of death in twin-to-twin transfusion syndrome treated with laser ablation of placental anastomoses. American journal of obstetrics and gynecology, 203(4), 388.e1-388.e11. https://doi.org/10.1016/j.ajog.2010.06.018