Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/199101
Type: Artigo de periódico
Title: [laser Ablation Of Placental Vessels For Treatment Of Severe Twin-twin Transfusion Syndrome--experience From An University Center In Brazil].
Author: Peralta, Cleisson Fábio Andrioli
Ishikawa, Luciana Emy
Bennini, João Renato
Braga, Angélica de Fátima Assunção
Rosa, Izilda Rodrigues Machado
Biondi, Maria Cristina
Abstract: To describe the results of laser ablation of placental vessels for the treatment of severe twin-to-twin transfusion syndrome in an university center in Brazil. Retrospective observational study of patients treated at UNICAMP from 2007 to 2009. Laser ablation of placental vessels was performed in cases of severe twin-twin transfusion syndrome (Quintero stages II, III and IV) diagnosed before 26 complete weeks of gestation. The main variables evaluated in this series were gestational age at delivery, survival (discharge from the nursery) of at least one twin and neurological damage in survivors. Logistic regression was used to investigate the influence of cervical length, gestational age and stage of the disease (before the surgery) on the occurrence of delivery/abortion and fetal death after the intervention, and the influence on severe preterm birth and survival. In the whole series, at least one twin survived in 63.3% of cases (19/30). Among patients who did not have delivery/abortion after surgery, the survival of at least one twin was 82.6% (19/23). In this subgroup (n=23), mean gestational age in delivery was 31.9 weeks and neurological damage was identified in one neonate (1/31; 3.2%). Cervix length influenced the occurrence of delivery/abortion after surgery (p-value=0.008). Among seven patients (7/30; 23.3%) who carried this complication, five (5/7; 71.4%) had cervix length lower than 15 mm. Among the 23 patients who did not have delivery/abortion as a result of the surgery, the highest stages of the disease (III and IV) increased the risk of delivery prior to 32 complete weeks of gestation (p-value=0.025) and decreased the chance of survival of both twins (p-value=0.026). The results are similar to those available in the literature. In our series, the main factors associated with poorer results were short cervix (lower than 15 mm) and the highest stages of the disease (III and IV) at the time of the treatment.
Subject: Adult
Brazil
Female
Fetofetal Transfusion
Hospitals, University
Humans
Laser Therapy
Placenta
Pregnancy
Retrospective Studies
Severity Of Illness Index
Young Adult
Rights: aberto
Identifier DOI: 
Address: http://www.ncbi.nlm.nih.gov/pubmed/21085750
Date Issue: 2010
Appears in Collections:Unicamp - Artigos e Outros Documentos

Files in This Item:
File SizeFormat 
pmed_21085750.pdf170.96 kBAdobe PDFView/Open


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.