Selective intrauterine growth restriction (SIUGR) type II: proposed subclassification to guide surgical management.
Fetal growth restriction (FGR)
laser surgery
monochorionic twins
selective reduction
staging
twin growth discordance
umbilical cord occlusion
Journal
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
ISSN: 1476-4954
Titre abrégé: J Matern Fetal Neonatal Med
Pays: England
ID NLM: 101136916
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
pubmed:
3
4
2020
medline:
23
2
2022
entrez:
3
4
2020
Statut:
ppublish
Résumé
Optimal surgical management of monochorionic diamniotic twins complicated by selective intrauterine growth restriction (SIUGR) type II is unknown. Surgical management may involve selective laser photocoagulation of communicating vessels (SLPCV), which offers the possibility of dual twin survivors versus umbilical cord occlusion (UCO) of the SIUGR twin. To identify patient characteristics associated with SIUGR twin survival for those undergoing SLPCV. All patients studied were those who underwent fetal treatment for SIUGR type II at our center from 2006-2018. SIUGR type II was defined as an estimated fetal weight <10th percentile with persistent absent and/or reversed end diastolic flow in the umbilical artery of the SIUGR twin, in the absence of twin-twin transfusion syndrome. Patients were offered SLPCV versus UCO, and those undergoing SLPCV, patient characteristics associated with 30-day survival of the SIUGR twin were examined using bivariate analysis and multiple logistic regression models. Fifty-four consecutive SIUGR type II patients were treated, 45 Over one-third of SIUGR type II patients experienced dual survival after treatment with laser surgery. Normal MCA psv and normal DV waveforms were associated with SIUGR type II survival of the SIUGR twin.
Sections du résumé
BACKGROUND
BACKGROUND
Optimal surgical management of monochorionic diamniotic twins complicated by selective intrauterine growth restriction (SIUGR) type II is unknown. Surgical management may involve selective laser photocoagulation of communicating vessels (SLPCV), which offers the possibility of dual twin survivors versus umbilical cord occlusion (UCO) of the SIUGR twin.
OBJECTIVE
OBJECTIVE
To identify patient characteristics associated with SIUGR twin survival for those undergoing SLPCV.
STUDY DESIGN
METHODS
All patients studied were those who underwent fetal treatment for SIUGR type II at our center from 2006-2018. SIUGR type II was defined as an estimated fetal weight <10th percentile with persistent absent and/or reversed end diastolic flow in the umbilical artery of the SIUGR twin, in the absence of twin-twin transfusion syndrome. Patients were offered SLPCV versus UCO, and those undergoing SLPCV, patient characteristics associated with 30-day survival of the SIUGR twin were examined using bivariate analysis and multiple logistic regression models.
RESULTS
RESULTS
Fifty-four consecutive SIUGR type II patients were treated, 45
CONCLUSION
CONCLUSIONS
Over one-third of SIUGR type II patients experienced dual survival after treatment with laser surgery. Normal MCA psv and normal DV waveforms were associated with SIUGR type II survival of the SIUGR twin.
Identifiants
pubmed: 32233709
doi: 10.1080/14767058.2020.1745177
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM