{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T12:11:17Z","timestamp":1785499877339,"version":"3.56.0"},"reference-count":16,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:00:00Z","timestamp":1691107200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>To investigate the outcomes of asymptomatic stage I twin\u2010to\u2010twin transfusion syndrome (stage I TTTS) among patients treated with fetoscopic laser photocoagulation (FLP) versus expectant management. Databases such as PubMed, Web of Science and Scopus were systematically searched from inception up to March 1st, 2022. The primary outcome was at least one fetal survival at birth and secondary outcomes included gestational age at delivery, preterm premature rupture of membranes\u00a0&lt;\u00a032\u00a0weeks, preterm birth\u00a0&lt;\u00a032\u00a0weeks, and single and dual fetal survival. Five studies were included in the meta\u2010analysis. There was no significant difference in terms of at least one survival (odds ratio (OR)\u00a0=\u00a01.40, 95%CI= (0.26, 7.43), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.70), single survival (OR\u00a0=\u00a00.87, 95%CI= (0.51, 1.48), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.60) and dual survival (OR\u00a0=\u00a01.63, 95%CI= (0.74, 3.62), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.23) among FLP and expectant groups. Gestational age at delivery (mean difference\u00a0=\u00a01.19, 95%CI= (\u22120.25, 2.63), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.10), the risk of PTB&lt;32\u00a0weeks (OR\u00a0=\u00a00.88, 95%CI= (0.50, 1.54), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.65), and pPROM&lt;32\u00a0weeks (OR\u00a0=\u00a01.80, 95% CI= (0.41, 7.98), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.44) were also comparable between the groups. Routine FLP of the placental anastomoses before 26\u00a0weeks of gestation is unlikely to be beneficial among asymptomatic stable stage I TTTS patients without cervical shortening as the procedure does not offer a survival advantage compared with expectant management.<\/jats:p>","DOI":"10.1002\/pd.6413","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T11:31:52Z","timestamp":1691148712000},"page":"1229-1238","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Fetoscopic laser photocoagulation versus expectant management for stage I twin\u2010to\u2010twin transfusion syndrome: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-7965","authenticated-orcid":false,"given":"Ahmed A.","family":"Nassr","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1722-3553","authenticated-orcid":false,"given":"Kamran","family":"Hessami","sequence":"additional","affiliation":[{"name":"Maternal Fetal Care Center Boston Children's Hospital Harvard Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1415-2086","authenticated-orcid":false,"given":"Nikan","family":"Zargarzadeh","sequence":"additional","affiliation":[{"name":"Maternal Fetal Care Center Boston Children's Hospital Harvard Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5859-9528","authenticated-orcid":false,"given":"Eyal","family":"Krispin","sequence":"additional","affiliation":[{"name":"Maternal Fetal Care Center Boston Children's Hospital Harvard Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1966-1306","authenticated-orcid":false,"given":"Shayan","family":"Mostafaei","sequence":"additional","affiliation":[{"name":"Division of Clinical Geriatrics Department of Neurobiology Care Sciences and Society Karolinska Institute  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mounira A.","family":"Habli","sequence":"additional","affiliation":[{"name":"Department of Maternal\u2010Fetal Medicine Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3801-346X","authenticated-orcid":false,"given":"Ramesha","family":"Papanna","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Gynecology and Reproductive Sciences UT Health Science Center at Houston  Houston Texas 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