scholarly journals Cervical length as a prognostic factor for preterm delivery in twin-to-twin transfusion syndrome treated by fetoscopic laser coagulation of chorionic plate anastomoses

2004 ◽  
Vol 25 (1) ◽  
pp. 37-41 ◽  
Author(s):  
R. Robyr ◽  
M. Boulvain ◽  
L. Lewi ◽  
A. Huber ◽  
K. Hecher ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Preterm Delivery ◽  
Cervical Length ◽  
Laser Coagulation ◽  
Chorionic Plate ◽  
Fetoscopic Laser Coagulation

scholarly journals P21.01: Is there an optimal gestational age for delivery following fetoscopic laser coagulation of chorionic plate?

2011 ◽  
Vol 38 (S1) ◽  
pp. 236-237
Author(s):  
T. Quibel ◽  
J. Stirnemann ◽  
A. Al-Ibrahim ◽  
M. Essaoui ◽  
Y. Ville
Keyword(s):  
Gestational Age ◽  
Laser Coagulation ◽  
Chorionic Plate ◽  
Fetoscopic Laser Coagulation

Prediction of Spontaneous Preterm Delivery in Twin Pregnancies By Cervical Length at Mid-Gestation

2008 ◽  
Vol 11 (5) ◽  
pp. 552-557 ◽  
Author(s):  
Katharina Klein ◽  
Hubertus Gregor ◽  
Kora Hirtenlehner-Ferber ◽  
Maria Stammler-Safar ◽  
Armin Witt ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Smoking Habit ◽  
Cervical Length ◽  
Spontaneous Preterm Delivery ◽  
Spontaneous Labour ◽  
High Incidence ◽  
High Cervical ◽  
Twin Pregnancies ◽  
Preterm Rupture Of Membranes ◽  
Spontaneous Delivery

AbstractThe objective of our study was to evaluate the correlation of the cervical length at 20–25 weeks of gestation with the incidence of spontaneous preterm delivery in twins in a country with a high incidence of preterm delivery compared to other European countries. Cervical length was measured in 262 consecutive patients. Previous preterm delivery before 34 weeks of gestation, chorionicity, maternal age, body-mass-index, smoking habit and parity were recorded as risk factors for preterm delivery. Women who were symptomatic at 20–25 weeks and who delivered because of other reasons than spontaneous labour and preterm rupture of membranes or at term were excluded. The primary outcome was incidence of preterm birth before 34 weeks. Two hundred and twenty-three patients were analyzed. Thirty-two (14%) delivered before 34 weeks. There was a significant correlation between cervical length of less than 25 mm and spontaneous delivery before 34 weeks (50% vs. 13%,p= .007). In addition, logistic regression analysis found cervical length to be the only significant predictor of spontaneous delivery before 34 weeks (OR 1.084; 95% CI 1.015; 1.159;p= .017). We conclude that the risk of severe preterm delivery in twins is high. Cervical length at mid-gestation was the only predictor of delivery before 34 weeks.

Demonstration of Placental Vascular Anatomy in Monochorionic Twin Gestations

2002 ◽  
Vol 5 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Monique E. De Paepe ◽  
Sarah Burke ◽  
Francois I. Luks ◽  
Halit Pinar ◽  
Don B. Singer
Keyword(s):  
Vascular Anatomy ◽  
Treatment Modalities ◽  
Laser Coagulation ◽  
Injection Technique ◽  
Invasive Treatment ◽  
Monochorionic Twin ◽  
Macroscopic Classification ◽  
Fetoscopic Laser Coagulation

Invasive treatment modalities for severe chronic twin-to-twin transfusion syndrome (TTTS), such as fetoscopic laser coagulation of communicating vessels, have revived the need for detailed studies of placental angioar-chitecture. We describe a practical placental vascular injection technique using alcohol-resistant tissue-staining dyes. Injection of color-coded gelatin-dye mixtures effectively delineated the intertwin vasculature, and allowed unequivocal macroscopic classification of vascular communications as artery-to-artery, vein-to-vein, or deep artery–to-vein anastomoses. The existence of deep artery–to-vein anastomoses was further confirmed by light microscopic demonstration of venous dye of one twin and arterial dye of the opposite twin within the same stem villus. Furthermore, the injection technique allowed determination of the caliber of the anastomoses, the direction of the artery-to-vein anastomoses, and the relative vascular territory of each twin. Documenting the vascular communications in monochorionic twin placentas with and without TTTS may enhance our understanding of the pathogenesis of chronic TTTS. Correlating the anastomotic patterns and location of the laser coagulation scars with post-ablation outcome will aid in the design of rational therapeutic methods for this often lethal condition.

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