Fetal growth changes and prediction of selective fetal growth restriction following fetoscopic laser coagulation in twin-to-twin transfusion syndrome
Objective To investigate fetal growth changes and predictive factors for selective fetal growth restriction (sFGR) in patients with twin-to-twin transfusion syndrome (TTTS) after fetoscopic laser coagulation (FLC). Methods This retrospective study included twin-pregnant women with fetal TTTS who und...
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| Format: | Article |
| Language: | English |
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Korean Society of Obstetrics and Gynecology
2023-11-01
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| Series: | Obstetrics & Gynecology Science |
| Subjects: | |
| Online Access: | http://www.ogscience.org/upload/pdf/ogs-23108.pdf |
| _version_ | 1797543051579621376 |
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| author | So Yeon Kim Hye-Sung Won Mi-Young Lee Jin Hoon Chung Jin-Hee Park You-Kyoung Kim Hwang-Mi Lee |
| author_facet | So Yeon Kim Hye-Sung Won Mi-Young Lee Jin Hoon Chung Jin-Hee Park You-Kyoung Kim Hwang-Mi Lee |
| author_sort | So Yeon Kim |
| collection | DOAJ |
| description | Objective To investigate fetal growth changes and predictive factors for selective fetal growth restriction (sFGR) in patients with twin-to-twin transfusion syndrome (TTTS) after fetoscopic laser coagulation (FLC). Methods This retrospective study included twin-pregnant women with fetal TTTS who underwent FLC at our institution between 2011 and 2020. Twin pairs who survived at least 28 days after FLC and at least 28 days after birth were included. A paired t-test was used to compare the mean discordance between the estimated fetal weights at the FLC and the birth weights. The predictive factors for sFGR after FLC were evaluated using univariate and multivariate logistic regression analyses. Results A total of 119 eligible pairs of patients who underwent FLC were analyzed. The weight percentile at birth significantly decreased after FLC in the recipients (53.7±30.4 percentile vs. 43.7±28.0 percentile; P<0.001), but increased in the donors (11.5±17.1 percentile vs. 20.7±22.8 percentile; P<0.001). Additionally, the mean weight discordance of twin pairs significantly decreased after FLC (23.9%±12.7% vs. 17.3%±15.7%; P<0.001). After FLC, Quintero stage ≥3, pre-FLC sFGR, abnormal cord insertion, and post-FLC abnormal umbilical artery Doppler (UAD) were all significantly higher in the sFGR group than the non-sFGR group. The prediction model using these variables indicated that the area under the receiver operating characteristic curve was 0.898. Conclusion The recipient weight percentile decreased, whereas donor growth increased, resulting in reduced weight discordance after FLC. The Quintero stage, pre-FLC sFGR, and post-FLC abnormal UAD were useful predictors of sFGR after FLC in TTTS. |
| first_indexed | 2024-03-10T13:39:11Z |
| format | Article |
| id | doaj.art-e623de85c2654951b56f49de4fb35563 |
| institution | Directory Open Access Journal |
| issn | 2287-8572 2287-8580 |
| language | English |
| last_indexed | 2024-03-10T13:39:11Z |
| publishDate | 2023-11-01 |
| publisher | Korean Society of Obstetrics and Gynecology |
| record_format | Article |
| series | Obstetrics & Gynecology Science |
| spelling | doaj.art-e623de85c2654951b56f49de4fb355632023-11-21T04:42:33ZengKorean Society of Obstetrics and GynecologyObstetrics & Gynecology Science2287-85722287-85802023-11-0166652953610.5468/ogs.231088782Fetal growth changes and prediction of selective fetal growth restriction following fetoscopic laser coagulation in twin-to-twin transfusion syndromeSo Yeon Kim0Hye-Sung Won1Mi-Young Lee2Jin Hoon Chung3Jin-Hee Park4You-Kyoung Kim5Hwang-Mi Lee6 Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea Department of Obstetrics and Gynecology, Asan Medical Center, Seoul, Korea Department of Obstetrics and Gynecology, Asan Medical Center, Seoul, Korea Department of Obstetrics and Gynecology, Asan Medical Center, Seoul, KoreaObjective To investigate fetal growth changes and predictive factors for selective fetal growth restriction (sFGR) in patients with twin-to-twin transfusion syndrome (TTTS) after fetoscopic laser coagulation (FLC). Methods This retrospective study included twin-pregnant women with fetal TTTS who underwent FLC at our institution between 2011 and 2020. Twin pairs who survived at least 28 days after FLC and at least 28 days after birth were included. A paired t-test was used to compare the mean discordance between the estimated fetal weights at the FLC and the birth weights. The predictive factors for sFGR after FLC were evaluated using univariate and multivariate logistic regression analyses. Results A total of 119 eligible pairs of patients who underwent FLC were analyzed. The weight percentile at birth significantly decreased after FLC in the recipients (53.7±30.4 percentile vs. 43.7±28.0 percentile; P<0.001), but increased in the donors (11.5±17.1 percentile vs. 20.7±22.8 percentile; P<0.001). Additionally, the mean weight discordance of twin pairs significantly decreased after FLC (23.9%±12.7% vs. 17.3%±15.7%; P<0.001). After FLC, Quintero stage ≥3, pre-FLC sFGR, abnormal cord insertion, and post-FLC abnormal umbilical artery Doppler (UAD) were all significantly higher in the sFGR group than the non-sFGR group. The prediction model using these variables indicated that the area under the receiver operating characteristic curve was 0.898. Conclusion The recipient weight percentile decreased, whereas donor growth increased, resulting in reduced weight discordance after FLC. The Quintero stage, pre-FLC sFGR, and post-FLC abnormal UAD were useful predictors of sFGR after FLC in TTTS.http://www.ogscience.org/upload/pdf/ogs-23108.pdffetal growthfetal growth restrictiontwin-to-twin transfusion syndromefetoscopic surgery |
| spellingShingle | So Yeon Kim Hye-Sung Won Mi-Young Lee Jin Hoon Chung Jin-Hee Park You-Kyoung Kim Hwang-Mi Lee Fetal growth changes and prediction of selective fetal growth restriction following fetoscopic laser coagulation in twin-to-twin transfusion syndrome Obstetrics & Gynecology Science fetal growth fetal growth restriction twin-to-twin transfusion syndrome fetoscopic surgery |
| title | Fetal growth changes and prediction of selective fetal growth restriction following fetoscopic laser coagulation in twin-to-twin transfusion syndrome |
| title_full | Fetal growth changes and prediction of selective fetal growth restriction following fetoscopic laser coagulation in twin-to-twin transfusion syndrome |
| title_fullStr | Fetal growth changes and prediction of selective fetal growth restriction following fetoscopic laser coagulation in twin-to-twin transfusion syndrome |
| title_full_unstemmed | Fetal growth changes and prediction of selective fetal growth restriction following fetoscopic laser coagulation in twin-to-twin transfusion syndrome |
| title_short | Fetal growth changes and prediction of selective fetal growth restriction following fetoscopic laser coagulation in twin-to-twin transfusion syndrome |
| title_sort | fetal growth changes and prediction of selective fetal growth restriction following fetoscopic laser coagulation in twin to twin transfusion syndrome |
| topic | fetal growth fetal growth restriction twin-to-twin transfusion syndrome fetoscopic surgery |
| url | http://www.ogscience.org/upload/pdf/ogs-23108.pdf |
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