Incidence and Causes of Intentional Fetal or Neonatal Demise in Twin-Twin Transfusion Syndrome.
Fetal Diagn Ther
; 43(1): 19-25, 2018.
Article
em En
| MEDLINE
| ID: mdl-28285310
ABSTRACT
INTRODUCTION:
The aim of this study is to evaluate the incidence and causes of intentional fetal and neonatal demise in twin-twin transfusion syndrome (TTTS). MATERIAL ANDMETHODS:
All TTTS pregnancies managed at our centre between 2000 and 2014 were included. We evaluated incidence and causes of intentional fetal/neonatal demise, defined as termination of pregnancy, selective fetal reduction, or withdrawal of neonatal intensive care.RESULTS:
Intentional fetal/neonatal demise occurred in 9.8% (110/1,122) of fetuses and was due to termination of pregnancy (2.2%), selective fetal reduction (4.2%), or withdrawal of neonatal intensive care (3.4%). Reasons for termination of pregnancy included complications of laser treatment (72.0%), severe fetal anomaly (20.0%), and unwanted pregnancy (8.0%). Reasons for selective fetal reduction were technical difficulties to perform laser surgery (51.1%), fetal complications (38.3%), and parental preference for fetal reduction rather than laser treatment (10.6%). Reasons for withdrawal of neonatal intensive care treatment were severe cerebral injury (47.4%), severe pulmonary complications (15.8%), birth asphyxia (5.3%), multiple complications of TTTS and/or prematurity combined (21.1%), or other (10.5%).CONCLUSIONS:
Intentional fetal or neonatal demise in TTTS occurs frequently and is often due to complications after laser surgery and/or severe (cerebral) injury in affected fetuses or neonates.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Terapia Intensiva Neonatal
/
Redução de Gravidez Multifetal
/
Suspensão de Tratamento
/
Terapia a Laser
/
Transfusão Feto-Fetal
/
Fetoscopia
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article