The neonatal outcome after fetoscopic laser surgery for twin–twin transfusion syndrome in Ha Noi Obstetrics and Gynecology hospital

Abstract

Objectives:To evaluate the outcome of neonatal survival results and short-term neurological complications after fetoscopic laser surgery (FLS)for twin–twin transfusion syndrome (TTTS)in HaNoi Obstetrics and Gynecology Hospital (HOGH).

Methods:A prospective study, data collectedwithin 12 months from October 2019andSeptember2020at HaNoi Obstetrics and Gynecology Hospital. 23 twins with a diagnosis of Twin-Twin Transfusion Syndrome (TTTS) stage II - IV according to Quintero classificationperformed laparoscopic surgery using laser coagulation. Solomon technique was applied for 12 cases to keep both fetuses and selected umbilical cord ablation would be performed for 11 casses to keep one fetus.

Results: The survival rate of at least 1 twin were 87%, the overall neonatal survival rate were 58,9%. No short-term neurological complications have been reported with follow-up of the newborn to 6 months postpartum. Average gestational age at birth were 33,05±4,04 weeks, The average time of additional pregnancy retention after surgery was 12,5± 4,97 weeks. 70% were born before 32^thgestationalweekand weight over 1500g, 3 cases of extremely preterm birth under 28 weeks, the birth weight is less than 1000gr.

Conclusion: Fetoscopic laser surgery to treat twin-twintransfusion syndrome at Hanoi Obstetrics and Gynecology Hospital has achieved high efficiencyandhigh birthrate, no short – term neurological complications have been reported with follow-up of the newborn up to 6 months postpartum. FLS seemto bean effective therapeutic option forstage II - IVTTTS before 26 weeks of gestation.