Operative fetoscopy in complicated monochorionic twins: Current status and future direction

Current Opinion in Obstetrics and Gynecology

Volumn 20, Issue 2, 2008, Pages 169-174

  Chmait, Ramen H ^a,c   Quintero, Rubén A ^b  

^a UNIVERSITY OF SOUTHERN CALIFORNIA   (United States)

^b UNIVERSITY OF SOUTH FLORIDA   (United States)

^c NONE   (United States)

Author keywords

Fetal surgery; Fetoscopy; Monochorionic; Twins

Indexed keywords

ARTERY PERFUSION; CLINICAL TRIAL; DIAGNOSTIC PROCEDURE; FETOSCOPY; GESTATIONAL AGE; HEALTH CENTER; HEMODYNAMIC STRESS; HEMODYNAMICS; HUMAN; INTRAUTERINE GROWTH RETARDATION; LASER SURGERY; LOW LEVEL LASER THERAPY; MONOCHORIONIC TWINS; OUTCOME ASSESSMENT; PERINATAL CARE; PRIORITY JOURNAL; REVIEW; TWIN DISCORDANCE; TWIN PREGNANCY; TWIN TWIN TRANSFUSION SYNDROME; TWINS; UMBILICAL CORD COMPLICATION;

DISEASES IN TWINS; FEMALE; FETOFETAL TRANSFUSION; FETOSCOPY; HUMANS; LASER THERAPY; PREGNANCY; PREGNANCY COMPLICATIONS; PREGNANCY OUTCOME; RISK ASSESSMENT; TWINS;

EID: 41849140863     PISSN: 1040872X     EISSN: None     Source Type: Journal    
DOI: 10.1097/GCO.0b013e3282f52f72     Document Type: Review

References (45)

1. Golombeck K, Ball RH, Lee H, et al. Maternal morbidity after maternal-fetal surgery. Am J Obstet Gynecol 2006; 194:834-839. This paper compares maternal and fetal morbidity rates between operative fetoscopy and open fetal surgery.
2. Deprest J, Jani J, Lewi L, et al. Fetoscopic surgery: encouraged by clinical experience and boosted by instrument innovation. Semin Fetal Neonatal Med 2006; 11:398-412. This paper is a review of operative fetoscopy that provides details regarding surgical instrumentations and techniques. Fetal conditions currently treated with fetoscopy are reviewed, including direct fetal treatments of conditions such as congenital diaphragmatic hernia.
3. Quintero R, Morales W. Operative fetoscopy: a new frontier in fetal medicine. Contemp Ob/Gyn 1999; 44:45-68.
4. Victoria A, Mora G, Arias F. Perinatal outcome, placental pathology, and severity of discordance in monochorionic and dichorionic twins. Obstet Gynecol 2001; 97:310-315.
5. Dube J, Dodds L, Armson BA. Does chorionicity or zygosity predict adverse perinatal outcomes in twins? Am J Obstet Gynecol 2002; 186:579-583.
6. Larroche JC, Droulle P, Delezoide AL, et al. Brain damage in monozygous twins. Biol Neonate 1990; 57:261-278.
7. Ong SS, Zamora J, Khan KS, Kilby MD. Prognosis for the co-twin following single-twin death: a systematic review. Bjog 2006; 113:992-998. This is a systematic review of 28 studies that report the perinatal morbidity and mortality rates for the surviving co-twin after in-utero demise of one twin, stratified by chorionicity.
8. Bajoria R, Kingdom J. The case for routine determination of chorionicity and zygosity in multiple pregnancy. Prenat Diagn 1997; 17:1207-1225.
9. Carroll SG, Soothill PW, Abdel-Fattah SA, et al. Prediction of chorionicity in twin pregnancies at 10-14 weeks of gestation. Bjog 2002; 109:182-186.
10. Quintero R, Quintero L, Bornick P, et al. The donor-recipient (D-R) score: in vivo endoscopic evidence to support the hypothesis of a net transfer of blood from donor to recipient in twin-twin transfusion syndrome. Prenat Neonat Med 2000; 5:84-91.
11. Bajoria R, Wigglesworth J, Fisk NM. Angioarchitecture of monochorionic placentas in relation to the twin- twin transfusion syndrome [see comments]. Am J Obstet Gynecol 1995; 172:856-863.
12. Mahieu-Caputo D, Meulemans A, Martinovic J, et al. Paradoxic activation of the renin-angiotensin system in twin-twin transfusion syndrome: an explanation for cardiovascular disturbances in the recipient. Pediatr Res 2005; 58:685-688.
13. Wieacker P, Wilhelm C, Prompeler H, et al. Pathophysiology of polyhydramnios in twin transfusion syndrome. Fetal Diagn Ther 1992; 7:87-92.
14. Quintero R, Morales W, Allen M, et al. Staging of twin-twin transfusion syndrome. J Perinatol 1999; 19:550-555.
15. Chang YL, Chmait RH, Bornick PW, et al. The role of laser surgery in dissecting the etiology of absent or reverse end-diastolic velocity in the umbilical artery of the donor twin in twin-twin transfusion syndrome. Am J Obstet Gynecol 2006; 195:478-483. This paper discusses the competing roles of the vascular communications and placental share in the etiology of TTTS and SIUGR.
16. Ishii K, Chmait RH, Martinez JM, et al. Ultrasound assessment of venous blood flow before and after laser therapy: approach to understanding the pathophysiology of twin-twin transfusion syndrome. Ultrasound Obstet Gynecol 2004; 24:164-168.
17. Saunders NJ, Snijders RJ, Nicolaides KH. Therapeutic amniocentesis in twin-twin transfusion syndrome appearing in the second trimester of pregnancy. Am J Obstet Gynecol 1992; 166:820-824.
18. Kontopoulos EV, Quintero RA, Chmait RH, et al. Percentage absent end-diastolic velocity in the umbilical artery waveform as a predictor of intrauterine fetal demise of the donor twin after selective laser photocoagulation of communicating vessels in twin-twin transfusion syndrome. Ultrasound Obstet Gynecol 2007; 30:35-39. This paper quantifies the duration of absence of umbilical artery end-diastolic flow and correlates it with perinatal outcome in the donor fetus in pregnancies complicated by TTTS and treated via SLPCV.
19. Mari G, Roberts A, Detti L, et al. Perinatal morbidity and mortality rates in severe twin-twin transfusion syndrome: results of the International Amnioreduction Registry. Am J Obstet Gynecol 2001; 185:708-715.
20. Hecher K, Plath H, Bregenzer T, et al. Endoscopic laser surgery versus serial amniocenteses in the treatment of severe twin-twin transfusion syndrome. Am J Obstet Gynecol 1999; 180 (3 Pt 1):717-724.
21. Quintero RA, Dickinson JE, Morales WJ, et al. Stage-based treatment of twin-twin transfusion syndrome. Am J Obstet Gynecol 2003; 188:1333-1340.
22. Cincotta RB, Gray PH, Phythian G, et al. Long term outcome of twin-twin transfusion syndrome. Arch Dis Child Fetal Neonatal Ed 2000; 83:F171-176.
23. Mari G, Detti L, Oz U, Abuhamad AZ. Long-term outcome in twin-twin transfusion syndrome treated with serial aggressive amnioreduction. Am J Obstet Gynecol 2000; 183:211-217.
24. Haverkamp F, Lex C, Hanisch C, et al. Neurodevelopmental risks in twin-to-twin transfusion syndrome: preliminary findings. Eur J Paediatr Neurol 2001; 5:21-27.
25. Frusca T, Soregaroli M, Fichera A, et al. Pregnancies complicated by twin-twin transfusion syndrome: outcome and long-term neurological follow-up. Eur J Obstet Gynecol Reprod Biol 2003; 107:145-150.
26. Lopriore E, Nagel HT, Vandenbussche FP, Walther FJ. Long-term neurodevelopmental outcome in twin-to-twin transfusion syndrome. Am J Obstet Gynecol 2003; 189:1314-1319.
27. Dickinson JE, Duncombe GJ, Evans SF, et al. The long term neurologic outcome of children from pregnancies complicated by twin-to-twin transfusion syndrome. Bjog 2005; 112:63-68.
28. Quintero R, Morales W, Mendoza G, et al. Selective photocoagulation of placental vessels in twin-twin transfusion syndrome: Evolution of a surgical technique. Obstet Gynecol Surv 1998; 53:s97-s103.
29. De Lia JE, Kuhlmann RS, Harstad TW, Cruikshank DP. Fetoscopic laser ablation of placental vessels in severe previable twin-twin transfusion syndrome. Am J Obstet Gynecol 1995; 172 (4 Pt 1):1202-1208; discussion 1208-1211.
30. Ville Y, Hyett J, Hecher K, Nicolaides K. Preliminary experience with endoscopic laser surgery for severe twin-twin transfusion syndrome. N Engl J Med 1995; 332:224-227.
31. Senat MV, Deprest J, Boulvain M, et al. Endoscopic laser surgery versus serial amnioreduction for severe twin-to-twin transfusion syndrome. N Engl J Med 2004; 351:136-144.
32. Lenclen R, Paupe A, Ciarlo G, et al. Neonatal outcome in preterm monochorionic twins with twin-to-twin transfusion syndrome after intrauterine treatment with amnioreduction or fetoscopic laser surgery: comparison with dichorionic twins. Am J Obstet Gynecol 2007; 196:450; e451-e457. This paper reports similar perinatal outcome of successfully laser treated TTTS pregnancies as compared to dichorionic twins. This supports the concept that laser therapy converts the pregnancy to a functional dichorionic twin gestation via ablation of placental vascular communications.
33. Crombleholme TM, Shera D, Lee H, et al. A prospective, randomized, multicenter trial of amnioreduction vs selective fetoscopic laser photocoagulation for the treatment of severe twin-twin transfusion syndrome. Am J Obstet Gynecol 2007; 197:e391-e399. This is the first report to show significantly worse outcome in the TTTS pregnancies treated by laser therapy versus amnioreduction in regards to recipient survival in Quintero Stage III/IV TTTS. Overall perinatal outcomes between the two groups were similar.
34. Chmait RH, Rossi AC, Quintero RA. Paradoxical scalloped placenta with polyhydramnios in twin-twin transfusion syndrome. J Matern Fetal Neonatal Med 2007; 20:29-32. Amnioreduction prior to laser therapy for TTTS may result in a scalloped placenta, as reported in this paper.
35. Quintero RA, Kontopoulos EV, Chmait R, et al. Management of twin-twin transfusion syndrome in pregnancies with iatrogenic detachment of membranes following therapeutic amniocentesis and the role of interim amniopatch. Ultrasound Obstet Gynecol 2005; 26:628-633.
36. Quintero RA, Ishii K, Chmait RH, et al. Sequential selective laser photocoagulation of communicating vessels in twin-twin transfusion syndrome. J Matern Fetal Neonatal Med 2007; 20:763-768. By occluding the vascular communications in a specific order, the intraoperative hemodynamic conditions for the fetuses afflicted with TTTS can be optimized. This technique resulted in improved dual survival rate.
37. James WH. A note on the epidemiology of acardiac monsters. Teratology 1977; 16:211-216.
38. Moore TR, Gale S, Benirschke K. Perinatal outcome of forty-nine pregnancies complicated by acardiac twinning. Am J Obstet Gynecol 1990; 163:907-912.
39. Quintero RA, Chmait RH, Murakoshi T, et al. Surgical management of twin reversed arterial perfusion sequence. Am J Obstet Gynecol 2006; 194:982-991. This paper describes an 11-year experience in the management of TRAP sequence using uniform criteria for surgical intervention. Using current surgical techniques, UCO was associated with improved outcomes compared to expectant management.
40. Quintero R, Reich H, Puder K, et al. Brief report: Umbilical-cord ligation of an acardiac twin by fetoscopy at 19 weeks of gestation. N Eng J Med 1994; 330:469-471.
41. Nicolini U, Poblete A, Boschetto C, et al. Complicated monochorionic twin pregnancies: experience with bipolar cord coagulation. Am J Obstet Gynecol 2001; 185:703-707.
42. Livingston JC, Lim FY, Polzin W, et al. Intrafetal radiofrequency ablation for twin reversed arterial perfusion (TRAP): a single-center experience. Am J Obstet Gynecol 2007; 197:e391-e393. Favorable short-term outcomes are presented using the intrafetal radiofrequency ablation technique for the treatment of TRAP sequence.
43. Morel O, Malartic C, Barranger E. Radiofrequency ablation for twin-reversed arterial perfusion sequence: the unknown cord occlusion delay calls for long term neonatal follow-up of the surviving twins [letter]. Am J Obstet Gynecol 2007; 197:557-558. This letter to the editor regarding intrafetal radiofrequency ablation for TRAP sequence discusses the theoretical risks of this technique and the need for longterm outcome studies.
44. Huber A, Diehl W, Zikulnig L, et al. Perinatal outcome in monochorionic twin pregnancies complicated by amniotic fluid discordance without severe twin-twin transfusion syndrome. Ultrasound Obstet Gynecol 2006; 27:48-52. This paper describes the natural history of monochorionic twins with amniotic fluid discordance that does not meet criteria for TTTS. A subgroup of patients in this study met criteria for SIUGR, and the perinatal outcomes were reviewed.
45. Quintero RA, Bornick PW, Morales WJ, Allen MH. Selective photocoagulation of communicating vessels in the treatment of monochorionic twins with selective growth retardation. Am J Obstet Gynecol 2001; 185:689-696.