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Fetoscopic Laser Surgery Improves Outcomes in Twins

Procedure reduces morbidity from twin-to-twin transfusion syndrome by more than half

WEDNESDAY, May 9 (HealthDay News) -- Fetoscopic laser surgery helps reduce morbidity associated with twin-to-twin transfusion syndrome (TTTS) in monochorionic twins, according to a report in the May issue of the American Journal of Obstetrics & Gynecology.

Richard Lenclen, M.D., of Unite de Reanimation Neonatale at Poissy, France, and colleagues studied the outcomes of 137 preterm neonates with TTTS treated with either amnioreduction or fetoscopic laser surgery and compared them to age-matched dichorionic twins delivered at 24 to 34 weeks of gestation.

The investigators found that 47.2 percent of TTTS infants treated with amnioreduction suffered severe cerebral lesions or died, compared to 20.8 treated with fetoscopic laser surgery and 13.2 percent of dichorionic twins. Within 30 weeks, morbidity was higher in the fetoscopic laser surgery group compared to dichorionic twins largely because of failed laser therapy.

Mary Norton, M.D., of the University of California San Francisco, cautions in an accompanying editorial that complications can still occur from fetoscopic laser surgery. "Like many techniques, there is a learning curve, and complications and success rates are operator dependent," she writes.

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