Perinatal outcomes of twin pregnancies affected by early twin-twin transfusion syndrome: A systematic review and meta-analysis.
cord occlusion
laser
meta-analysis
monochorionic
systematic review
twin-twin transfusion syndrome
twins
Journal
Acta obstetricia et gynecologica Scandinavica
ISSN: 1600-0412
Titre abrégé: Acta Obstet Gynecol Scand
Pays: United States
ID NLM: 0370343
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
29
10
2019
revised:
28
02
2020
accepted:
08
03
2020
pubmed:
13
3
2020
medline:
25
11
2020
entrez:
13
3
2020
Statut:
ppublish
Résumé
Twin-to-twin transfusion syndrome (TTTS) is associated with a high risk of perinatal mortality and morbidity if not treated. However, the optimal timing and management in case of early (occurring < 18 weeks) TTTS has not been established yet. This is a systematic review and meta-analysis aiming at evaluating the outcomes of monochorionic diamniotic twin pregnancies complicated by early (ie before 18 weeks) TTTS according to different management options (expectant, laser therapy, amnioreduction or cord occlusion). The primary outcome was mortality, including single and double intrauterine, neonatal and perinatal death. Secondary outcomes were: composite morbidity, neuromorbidity, respiratory distress syndrome, admission to neonatal intensive care unit, intact survival (defined as survival free from neurological complications) and preterm birth < 32 weeks of gestation. All outcomes were reviewed according to the different management options (expectant, laser therapy, amnioreduction or cord occlusion) and reported FOR the overall population of twins, and for the donor and recipient separately. Subgroup analysis for TTTS occurring before 16 weeks of gestation was performed. Random-effect meta-analyses of proportions were used to analyse the data. Thirteen studies were included. Early TTTS occurred in 14.3% (95% confidence interval [CI] 11.9-17.0) of cases. The incidence of intrauterine death was 19.0% (95% CI 2.6-45.5) in twins managed expectantly, 32.4% (95% CI 16.5-50.7) in those who received laser treatment and 12.5% (95% CI 4.8-23.0) in those treated with amnioreduction. The incidence of neonatal death was 22.6% (95% CI 4.2-49.8) in twins managed expectantly, 24.7% (95% CI 0.5-80.3) in those who received laser and 20.2 (95% CI 5.8-43.4) in those who had amnioreduction; it was not possible to compute the incidence of these outcomes in twins undergoing cord occlusion because of insufficient sample and lack of reporting of most of the observed outcomes. Overall, the incidence of perinatal death was 43.9% (95% CI 5.9-87.7) in twins managed expectantly, 47.3% (95% CI 21.4-70.0) in those treated with laser and 28.5% in those who had amnioreduction. Twin pregnancies affected by early TTTS are at substantial risk of perinatal mortality and morbidity; however, the data come from very small studies with a high risk of selection bias.
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1121-1134Informations de copyright
© 2020 Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). Published by John Wiley & Sons Ltd.
Références
Mosquera C, Miller RS, Simpson LL. Twin-twin transfusion syndrome. Semin Perinatol. 2012;36:182-189.
Lewi L, Deprest J, Hecher K. The vascular anastomoses in monochorionic twin pregnancies and their clinical consequences. Am J Obstet Gynecol. 2013;208:19-30.
Simpson LL. Twin-twin transfusion syndrome. Am J Obstet Gynecol. 2013;208:3-18.
Roberts D, Gates S, Kilby M, Neilson JP. Interventions for twin-twin transfusion syndrome: a Cochrane review. Ultrasound Obstet Gynecol. 2008;31:701-711.
DeKoninck P, Deprest J, Lewi P, et al. Gestational age-specific reference ranges for amniotic fluid assessment in monochorionic diamniotic twin pregnancies. Ultrasound Obstet Gynecol. 2013;41:649-652.
Lecointre L, Sananes N, Weingertner AS, et al. Fetoscopic laser coagulation for twin-twin transfusion syndrome before 17 weeks of gestation: laser data, complications and neonatal outcome. Ultrasound Obstet Gynecol. 2014;44:299-303.
Khalil A. Modified diagnostic criteria for twin-to-twin transfusion syndrome prior to 18 weeks of gestation: time to change? Ultrasound Obstet Gynecol. 2017;49:804-805.
Diehl W, Diemert A, Grasso D, Sehner S, Wegscheider K, Hecher K. Fetoscopic laser coagulation in 1020 pregnancies with twin-twin transfusion syndrome demonstrates improvement in double-twin survival rate. Ultrasound Obstet Gynecol. 2017;50:728-735.
Rossi AC, D’Addario V. Umbilical cord occlusion for selective feticide in complicated monochorionic twins: a systematic review of literature. Am J Obstet Gynecol. 2009;200:123-129.
Van Klink J, Koopman H, Rijken M, Middeldorp J, Oepkes D, Lopriore E. Long-term neurodevelopmental outcome in survivors of twin-to-twin transfusion syndrome. Twin Res Hum Genet. 2016;19:255-261.
Quintero RA, Dickinson JE, Morales WJ, et al. Stage-based treatment of twin-twin transfusion syndrome. Am J Obstet Gynecol. 2003;188:1333-1340.
Lopriore E, Ortibus E, Acosta-Rojas R, et al. Risk factors for neurodevelopment impairment in twin-twin transfusion syndrome treated with fetoscopic laser surgery. Obstet Gynecol. 2009;113:361-366.
Baud D, Windrim R, Keunen J, et al. Fetoscopic laser therapy for twin-twin transfusion syndrome before 17 and after 26 weeks of gestation. Am J Obstet Gynecol. 2013;208:197.e1-197.e7.
Prisma statement. http://www.prisma-statement.org/. Accessed July 10, 2016.
Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283:2008-2012.
Wells GA, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed February 17, 2014.
Murad MH, Sultan S, Haffar S, Bazerbachi F. Methodological quality and synthesis of case series and case reports. BMJ Evid Based Med. 2018;23:60-63.
Higgins J, Thompson S, Deeks J, Altman D. Statistical heterogeneity in systematic reviews of clinical trials: a critical appraisal of guidelines and practice. J Health Serv Res Policy. 2002;7:51-61.
Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629-634.
Hunter JP, Saratzis A, Sutton AJ, Boucher RH, Sayers RD, Bown MJ. In meta-analyses of proportion studies, funnel plots were found to be an inaccurate method of assessing publication bias. J Clin Epidemiol. 2014;67:897-903.
Blaicher W, Ulm B, Ulm M, Kuhle S, Deutinger J, Bernaschek G. The twin-twin transfusion syndrome - an unsolved problem. Ultraschall Med. 2002;23:108-112.
Dennis LG, Winkler CL. Twin-to-twin transfusion syndrome: aggressive therapeutic amniocentesis. Am J Obstet Gynecol. 1997;177:342-349.
Elliott JP, Urig MA, Clewell WH. Aggressive therapeutic amniocentesis for treatment of twin-twin transfusion syndrome. Obstet Gynecol. 1991;77:537-540.
Has R, Akhan S, Topuz S, Ermiş H, Iyibozkurt C, Ibrahimoğlu L. Therapeutic amniocentesis for treatment of twin-twin transfusion syndrome. Arch Gynecol Obstet. 2005;271:22-25.
Johnson JR, Rossi KQ, O’Shaughnessy RW. Amnioreduction versus septostomy in twin-twin transfusion syndrome. Am J Obstet Gynecol. 2001;185:1044-1047.
Lim YK, Tan TY, Zuzarte R, Daniel ML, Yeo GS. Outcomes of twin-twin transfusion syndrome managed by a specialised twin clinic. Singapore Med J. 2005;46:401-406.
Mahieu-Caputo D, Salomon LJ, Le Bidois J, et al. Fetal hypertension: an insight into the pathogenesis of the twin-twin transfusion syndrome. Prenat Diagn. 2003;23:640-645.
Mari G, Detti L, Oz U, Abuhamad AZ. Long-term outcome in twin-twin transfusion syndrome treated with serial aggressive amnioreduction. Am J Obstet Gynecol. 2000;183:211-217.
Sebire NJ, D’Ercole C, Carvelho M, Sepulveda W, Nicolaides KH. Inter-twin membrane folding in monochorionic pregnancies. Ultrasound Obstet Gynecol. 1998;11:324-327.
Sepulveda W, Wong AE, Dezerega V, Devoto JC, Alcalde JL. Endoscopic laser surgery in severe second-trimester twin-twin transfusion syndrome: a three-year experience from a Latin American center. Prenat Diagn. 2007;27:1033-1038.
Willruth A, Geipel A, Berg C, Fimmers R, Gembruch U. Assessment of cardiac function in monochorionic diamniotic twin pregnancies with twin-to-twin transfusion syndrome before and after fetoscopic laser photocoagulation using Speckle tracking. Ultraschall Med. 2013;34:162-168.
Khalil A, Cooper E, Townsend R, Thilaganathan B. Evolution of stage 1 twin-to-twin transfusion syndrome (TTTS): systematic review and meta-analysis. Twin Res Hum Genet. 2016;19:207-216.
Washburn EE, Sparks TN, Gosnell KA, Rand L, Gonzalez JM, Feldstein VA. Stage I twin-twin transfusion syndrome: outcomes of expectant management and prognostic features. Am J Perinatol. 2018;35:1352-1357.
Senat MV, Deprest J, Boulvain M, Paupe A, Winer N, Ville Y. Endoscopic laser surgery versus serial amnioreduction for severe twin-to-twin transfusion syndrome. N Engl J Med. 2004;351:136-144.
Ville Y, Hecher K, Gagnon A, Sebire N, Hyett J, Nicolaides K. Endoscopic laser coagulation in the management of severe twin-to-twin transfusion syndrome. Br J Obstet Gynaecol. 1998;105:446-453.
Khalil A, Rodgers M, Baschat A, et al. ISUOG Practice Guidelines: role of ultrasound in twin pregnancy. Ultrasound Obstet Gynecol. 2016;47:247-263.
Mari G, Roberts A, Detti L, et al. Perinatal morbidity and mortality rates in severe twin-twin transfusion syndrome: results of the International Amnioreduction Registry. Am J Obstet Gynecol. 2001;185:708-715.
Salomon LJ, Örtqvist L, Aegerter P, et al. Long-term developmental follow-up of infants who participated in a randomized clinical trial of amniocentesis vs laser photocoagulation for the treatment of twin-to-twin transfusion syndrome. Am J Obstet Gynecol. 2010;203:444.e1-444.e7.
Bebbington MW, Danzer E, Moldenhauer J, Khalek N, Johnson MP. Radiofrequency ablation vs bipolar umbilical cord coagulation in the management of complicated monochorionic pregnancies. Ultrasound Obstet Gynecol. 2012;40:319-324.
Perry H, Duffy JMN, Umadia O, Khalil A. International Collaboration to Harmonise Outcomes for Twin-Twin Transfusion Syndrome (CHOOSE). Outcome reporting across randomized trials and observational studies evaluating treatments for twin-twin transfusion syndrome: systematic review. Ultrasound Obstet Gynecol. 2018;52:577-585.