{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T13:51:54Z","timestamp":1767966714254,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2007,8,17]],"date-time":"2007-08-17T00:00:00Z","timestamp":1187308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2007,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>In order to assess the outcome of pregnancies complicated by severe second trimester twin\u2010twin transfusion syndrome (TTTS) undergoing treatment with endoscopic laser surgery, we reviewed our experience following the implementation of an institutional fetal surgery program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients presenting with monochorionic\u2010diamniotic twin pregnancies complicated by severe TTTS before 26 weeks of gestation were offered endoscopic laser surgery to coagulate placental vascular anastomoses. Using regional anesthesia and guided by real\u2010time sonography, anastomoses were identified and selectively coagulated. At the end of the procedure, amniodrainage was performed to restore normal amniotic fluid volume. Follow\u2010up and delivery were carried out at the referring institutions. Six\u2010month follow\u2010up was performed in all cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During a 3\u2010year period from September 2003 to December 2006, 33 consecutive cases of severe TTTS were operated on at a median gestational age of 21 weeks (range 17\u201325). Nine (27.3%) cases were classified as stage II, 21 (63.6%) as stage III, and three (9.1%) as stage IV. The placenta was anterior or predominantly anterior in 15 (45.5%) of the cases. Overall, both twins were born alive in 16 (48.5%) cases, only one twin was born alive in 11 (33.3%), and neither was born alive in the remaining six (18.2%). Therefore, 81.8% (27 of 33) of the pregnancies resulted in at least one liveborn infant. Among them, the mean gestational age at delivery was 32 weeks (range 23\u201338) and the mean birthweight of the liveborn infants was 1591 g (range 350\u20133800). Thirty\u2010four infants survived the perinatal period, yielding an overall perinatal survival rate of 51.5%, with 75.8% (25 of 33) of the pregnancies resulting in at least one perinatal survivor. All neonatal deaths were associated with extreme prematurity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This preliminary experience suggests that selective laser coagulation appears to be a good treatment option in cases of monochorionic twin pregnancies complicated by severe TTTS. However, technical skills and adequate equipment are required for implementing a fetal surgery program. Auditing outcomes during the learning curve would help in identifying potential problems. Copyright \u00a9 2007 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.1829","type":"journal-article","created":{"date-parts":[[2007,8,17]],"date-time":"2007-08-17T16:50:36Z","timestamp":1187369436000},"page":"1033-1038","source":"Crossref","is-referenced-by-count":32,"title":["Endoscopic laser surgery in severe second\u2010trimester twin\u2010twin transfusion syndrome: a three\u2010year experience from a Latin American center"],"prefix":"10.1002","volume":"27","author":[{"given":"Waldo","family":"Sepulveda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy E.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Dezerega","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan C.","family":"Devoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan L.","family":"Alcalde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,8,17]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(95)90011-X"},{"key":"e_1_2_1_3_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_4_1","doi-asserted-by":"publisher","DOI":"10.1515\/JPM.1999.007"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(199712)17:13<1227::AID-PD328>3.0.CO;2-4"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000161322.92539.23"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1264"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1375\/twin.9.3.438"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(00)00437-1"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000097116"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.08.062"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.117188"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000098715"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.01.067"},{"key":"e_1_2_1_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200292"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-199812010-00001"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2000.00265.x"},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000091361"},{"key":"e_1_2_1_19_1","first-page":"777","volume-title":"Diagnostic Imaging of Fetal Anomalies","author":"Sebire NJ","year":"2003"},{"key":"e_1_2_1_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032597"},{"key":"e_1_2_1_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.256"},{"key":"e_1_2_1_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/plac.2001.0758"},{"key":"e_1_2_1_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001703-200104000-00015"},{"key":"e_1_2_1_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199501263320404"},{"key":"e_1_2_1_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1998.tb10132.x"},{"key":"e_1_2_1_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2004.04.007"}],"container-title":["Prenatal Diagnosis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpd.1829","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pd.1829","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:36:08Z","timestamp":1700008568000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/pd.1829"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,8,17]]},"references-count":25,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2007,11]]}},"alternative-id":["10.1002\/pd.1829"],"URL":"https:\/\/doi.org\/10.1002\/pd.1829","archive":["Portico"],"relation":{},"ISSN":["0197-3851","1097-0223"],"issn-type":[{"value":"0197-3851","type":"print"},{"value":"1097-0223","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,8,17]]}}}