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Laser surgery of the chorionic plate inter\u2010twin anastomoses is the best first\u2010line treatment when the syndrome develops before 26 weeks' gestation. Survival (including quality of survival) and gestational age at delivery are improved when compared to serial amnioreduction. Second\u2010line treatment options include repeat\u2010laser, intra\u2010uterine blood transfusion, serial amnioreduction, selective feticide using bipolar cord coagulation or elective delivery, depending upon gestational age and the severity of the disease and its complications. We have found that fetoscopic placental surgery has proven itself over simplicity of amnioreduction. There is no evidence that treatment should be customized according to the stage of the disease at diagnosis. Early recognition of the syndrome through fortnightly serial ultrasound follow\u2010up of all monochorionic pregnancies should ensure timely referral and make up for geographical constraints. Laser surgery should now be available in fetal medicine units that are managing at least 20 cases per year. Copyright \u00a9 2005 John Wiley &amp; Sons, Ltd.<\/jats:p>","DOI":"10.1002\/pd.1271","type":"journal-article","created":{"date-parts":[[2005,9,19]],"date-time":"2005-09-19T11:18:34Z","timestamp":1127128714000},"page":"786-795","source":"Crossref","is-referenced-by-count":35,"title":["Management of fetofetal transfusion syndrome"],"prefix":"10.1002","volume":"25","author":[{"given":"R.","family":"Robyr","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Quarello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Ville","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,9,19]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/13.6.1709"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.202"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(90)90024-2"},{"key":"e_1_2_1_5_1","first-page":"1499","article-title":"Twin placenta in perinatal mortality","volume":"61","author":"Benirschke K","year":"1961","journal-title":"N Y State J Med"},{"issue":"5","key":"e_1_2_1_6_1","first-page":"480","article-title":"Natural history of twin\u2010twin transfusion syndrome","volume":"46","author":"Berghella V","year":"2001","journal-title":"J Reprod Med"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.10.465"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1515\/JPM.1999.046"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/fn.83.3.F171"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.1997.16.12.853"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)24029-2"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-199609000-00009"},{"issue":"6","key":"e_1_2_1_13_1","first-page":"1046","article-title":"Fetoscopic neodymium: YAG laser occlusion of placental vessels in severe twin\u2010twin transfusion syndrome","volume":"75","author":"De Lia JE","year":"1990","journal-title":"Obstet Gynecol"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1515\/JPM.1999.007"},{"key":"e_1_2_1_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(95)91480-3"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(98)70424-7"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(98)00181-X"},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.104236"},{"issue":"11","key":"e_1_2_1_19_1","first-page":"747","article-title":"Selective feticide by embolization in twin\u2010twin transfusion syndrome. 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