Twin-twin transfusion and laser therapy
Nicholas Behrendt1, Henry L Galan
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Colorado Institute for Maternal and Fetal Health, Aurora, Colorado, USA.
Current Opinion in Obstetrics & Gynecology
|February 13, 2016
Summary
Laser therapy is the only treatment that stops twin-to-twin transfusion syndrome (TTTS), improving survival rates. The Solomon laser technique shows promise in reducing complications like recurrent TTTS and twin anemia-polycythemia syndrome.
Area of Science:
- Maternal-Fetal Medicine
- Fetal Surgery
- Neonatal Neurology
Background:
- Twin-to-twin transfusion syndrome (TTTS) is a severe complication of monochorionic diamniotic twin pregnancies.
- Effective management is crucial to improve fetal and neonatal outcomes.
Purpose of the Study:
- To provide an updated review of evolving treatments for TTTS, focusing on laser photocoagulation.
- To present recent findings on TTTS outcomes and neurodevelopmental complications.
Main Methods:
- Review of recent literature on TTTS treatments and outcomes.
- Focus on laser photocoagulation techniques, including the Solomon technique.
- Integration of fetal echocardiography in TTTS staging.
Main Results:
- The Solomon laser technique reduces complications such as recurrent TTTS and twin anemia-polycythemia syndrome.
- Post-laser neurodevelopmental delay occurs in 14% of TTTS cases.
- Untreated TTTS carries a 25% risk of severe neurodevelopmental morbidity in survivors.
Conclusions:
- Laser therapy is the definitive treatment for TTTS, halting disease progression and improving survival.
- The Solomon technique represents an advancement in laser therapy, mitigating certain post-procedural complications.
- Future research should focus on understanding TTTS pathophysiology, refining staging, and comparing laser techniques to minimize neurodevelopmental morbidity.
