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STUDY TO DETERMINE THE FETAL SURVIVAL IMMEDIATE AFTER FETOSCOPIC LASER ABLATION IN TWIN TO TWIN TRANSFUSION SYNDROME

Dr Sofia Amber Malik

Objective: The aim of this analysis was to conclude the prognostic factors that may affect fetal survival immediately after laser fetoscopic ablation. Study Design: A retrospective study. Place and Duration: In the Obstetrics and Gynaecology department of Alzahra Pvt Hospital, Sharjah for two year duration from May 2017 till May 2019. Methods: In this study 57 consecutive twins pregnant women who were done with fetoscopic laser ablation for the TTTS (twin to twin transfusion syndrome) diagnosis were selected. After the procedure; immediate survival was defined as within 48 hours and neonatal survival after 28 days. At the end of the procedure, clinical features and findings of ultrasound were compared with fetal survival. Results: Fifty-seven TTTS pregnant women were enrolled and after laser fetoscopic ablation fetal survival rate was 71.2% (81/114). The gestational age was higher in the foetuses who survived immediately after the method and the abnormal Doppler studies frequency was lower than those who did not endure. Though, the hydrops frequency was not dissimilar between patients with fetal death and fetal survival. The abnormal Doppler studies presence and early age of gestation were important risk aspects for the death of fetus even after adjustment. Conclusion: According to these data, immediate survival of foetus (treatment with fetoscopic laser ablation) in TTTS may be affected by age of gestation in the procedure and if there were abnormal Doppler studies. Keywords: Twin to twin transfusion syndrome; Fetoscopic laser ablation; Twin receiver, Twin donors.

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