Predictors of fetal death, neonatal survival and neurological outcomes in severe twin-twin transfusion syndrome treated by laser ablation of placental vessels.

Autor: Andrioli Peralta CF; Fetal Medicine Unit, Heart Hospital (HCor), São Paulo, São Paulo, Brazil.; Fetal Medicine and Surgery Center (Gestar), São Paulo, São Paulo, Brazil.; Research Institute (HCor), São Paulo, São Paulo, Brazil., Jorge Rodrigues da Costa K; Fetal Medicine Unit, Heart Hospital (HCor), São Paulo, São Paulo, Brazil.; Fetal Medicine and Surgery Center (Gestar), São Paulo, São Paulo, Brazil.; Research Institute (HCor), São Paulo, São Paulo, Brazil., Peneluppi Horak AC; Research Institute (HCor), São Paulo, São Paulo, Brazil., Pinheiro do Carmo Gomes S; Research Institute (HCor), São Paulo, São Paulo, Brazil., Sousa Santos E; Research Institute (HCor), São Paulo, São Paulo, Brazil., Galvão Barbante L; Research Institute (HCor), São Paulo, São Paulo, Brazil., Hideo Nakagawa Santos R; Research Institute (HCor), São Paulo, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Prenatal diagnosis [Prenat Diagn] 2024 Mar; Vol. 44 (3), pp. 325-335. Date of Electronic Publication: 2024 Jan 19.
DOI: 10.1002/pd.6523
Abstrakt: Objectives: To identify predictors of outcomes in severe twin oligo-polyhydramnios sequence (TOPS) with or without twin anemia-polycythemia sequence (TAPS) and/or selective fetal growth restriction (SFGR) treated by laser ablation of placental vessels (LAPV).
Methods: Analysis of cases treated from 2011 to 2022. Variables evaluated Prenatal predictors: stages of TOPS, presence of TAPS and/or SFGR; pre-LAPV fetal ultrasound parameters; peri-LAPV variables. Perinatal predictors: GA at birth; birthweight; Apgar scores; transfontanellar ultrasonography (TFUS).
Outcome Variables: fetal death, neonatal survival, infant's neurodevelopment. Binary logistic regression analyses were performed to detect predictors of outcomes.
Results: 265 cases were included. Predictors of post-LAPV donor fetus' death were delta EFW (p:0.045) and absent/reverse end-diastolic flow in the umbilical artery (AREDF-UA) (p < 0.001). The predictor of post-LAPV recipient fetus' death was hydrops (p:0.009). Predictors of neonatal survival were GA at birth and Apgar scores. Predictors of infant's neurodevelopment were TFUS and pre-LAPV middle cerebral artery Doppler (MCAD) for the donor twin; and pre-LAPV ductus venosus' flow and MCAD for the recipient twin.
Conclusions: Prediction of fetal death, neonatal survival and infant's neurodevelopment is possible in cases of TOPS associated or not with SFGR and/or TAPS that were treated by LAPV.
(© 2024 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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