Doppler Finding, Cardiovascular Function Assessment, and Fetuses' Survival Following the Fetoscopic Laser in Twin-to-Twin Transfusion Syndrome

Tahmineh Ezazi Bojnordi; Laleh Eslamian; Vajiheh Marsoosi; Alireza Golbabaei; Mehrdad Sheikh Vatan; Alireza A Shamshirsaz; Nasim Eshraghi; Marjan Ghaemi

doi:10.34172/jlms.2023.64

Doppler Finding, Cardiovascular Function Assessment, and Fetuses' Survival Following the Fetoscopic Laser in Twin-to-Twin Transfusion Syndrome

J Lasers Med Sci. 2023 Dec 26:14:e64. doi: 10.34172/jlms.2023.64. eCollection 2023.

Authors

Tahmineh Ezazi Bojnordi¹, Laleh Eslamian¹, Vajiheh Marsoosi¹, Alireza Golbabaei², Mehrdad Sheikh Vatan¹, Alireza A Shamshirsaz³, Nasim Eshraghi⁴, Marjan Ghaemi⁴

Affiliations

¹ Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
² Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
³ Maternal Fetal Care Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
⁴ Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: This study aimed to evaluate the effectiveness of selective laser photocoagulation of communicating vessels (SLPCV) on cardiac function in twins with twin-to-twin transfusion syndrome (TTTS). Methods: This retrospective cohort study evaluated 178 women with twin pregnancies complicated with TTTS and scheduled for SLPCV between 16 and 26 weeks of gestation. The severity of TTTS was determined by Quintero staging and the severity of cardiovascular disorders by the CHOP (Children's Hospital of Philadelphia) score. Patient survival was evaluated through a one-month-after-birth follow-up of fetuses. Results: The study revealed significant improvements in Doppler indices in both donors and recipients after SLPCV. The CHOP score also significantly decreased after the intervention. One-month-after-birth survival rates were 55.1% in donors and 56.7% in recipients. Some Doppler indexes of fetuses before SLPCV could predict survival until one month after birth. Conclusion: The study suggests that SLPCV can improve cardiac function in fetuses with TTTS and that some Doppler indexes can predict survival outcomes. Additionally, the severity of TTTS can be a powerful indicator of the severity of cardiovascular complications.

Keywords: CHOP score; Fetal surgery; Laser photocoagulation; Twin-to-twin transfusion syndrome.