OC17.05: Risk factors and outcomes associated with intraoperative septotomy during laser surgery for Twin–twin transfusion syndrome
Year: 2021
Type: conference-abstract
Abstract: To identify risk factors and outcomes associated with intraoperative septostomy (IOS) during fetoscopic laser surgery (FLS) for Twin–twin transfusion syndrome (TTTS). This is an analysis of a consecutive prospective cohort of patients that had FLS for TTTS from 2011 to 2020. FLS was offered at our centre to all patients with Stage II–IV TTTS and Stage I TTTS in the setting symptomatic polyhydramnios or short cervix (i.e. <3cm). Patients with versus without IOS were compared to determine preoperative/intraoperative risk factors for IOS. Neonatal and delivery outcomes were also compared between these two groups. 475 women underwent FLS for TTTS; 33 (6.9%) had IOS. IOS was more likely for FLS at later gestational ages (20.3 vs 21.9 wks, p < 0.01). Selective fetal growth restriction was associated with decreased risk (24.2% vs 45.2%, p = 0.02) of IOS. IOS was not associated with any specific recorded intraoperative technique (i.e. cannula size, energy used, laser time, Solomon technique, amnioinfusion). IOS was associated with earlier GA at delivery (29.5 vs 31.0 wks, p < 0.01) and a shorter interval between FLS and delivery (7.4 vs 10.5 wks, p < 0.01). Patients with IOS were delivered for similar indications with similar survival as those without IOS. However, morbidity was more common following IOS (figure 1). Earlier diagnosis of TTTS may decrease the risk of IOS while operative techniques were not determined to be a risk factors. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
DOI: 10.1002/uog.23903
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3206834909