{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:49:21Z","timestamp":1771548561498,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,9,22]],"date-time":"2014-09-22T00:00:00Z","timestamp":1411344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate management and outcome of iatrogenic monoamniotic twins (iMAT) compared with twins with intact intertwin dividing membranes after laser surgery for twin\u2010to\u2010twin transfusion syndrome (TTTS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective analysis of twins with and without iatrogenic rupture of the intertwin membranes that had been treated for TTTS with laser surgery at our center between 2004 and 2012. Primary outcomes were perinatal survival and severe neonatal morbidity. Secondary outcomes were mode of delivery, gestational age at birth and cord entanglement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 338 pregnancies were included. In 67\/338 (20%) pregnancies, iMAT was suspected antenatally. In 47 of these 67 (70%), a preterm Cesarean section was performed for monoamnionicity. Perinatal survival was 108\/134 (81%) <jats:italic>vs<\/jats:italic> 396\/542 (73%) in twins with intact intertwin membranes (<jats:italic>P<\/jats:italic>\u2009=\u20090.13). Mean gestational age at birth in iMAT was 31 completed weeks, compared to 33 weeks in twins with intact membranes (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). At birth, cord entanglement was present in 8\/67 (12%) iMAT pregnancies. Severe neonatal morbidity was assessed in 106\/110 (96%) in iMAT cases and 392\/416 (94%) in controls. The incidence of severe neonatal morbidity was 28\/106 (26%) in iMAT <jats:italic>vs<\/jats:italic> 72\/392 (18%) in controls (<jats:italic>P<\/jats:italic>\u2009=\u20090.25). Severe cerebral injury was significantly increased in the iMAT group as compared with controls, at 16\/106 (15%) <jats:italic>vs<\/jats:italic> 18\/392 (5%) (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Iatrogenic rupture of intertwin membranes was suspected in 20% of pregnancies treated with laser therapy for TTTS and was associated with a lower gestational age at birth and increased neonatal morbidity. Copyright \u00a9 2014 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.13445","type":"journal-article","created":{"date-parts":[[2014,6,24]],"date-time":"2014-06-24T22:06:13Z","timestamp":1403647573000},"page":"550-556","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Iatrogenic perforation of intertwin membrane after laser surgery for twin\u2010to\u2010twin transfusion syndrome"],"prefix":"10.1002","volume":"44","author":[{"given":"S. H. P.","family":"Peeters","sequence":"first","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. T.","family":"Stolk","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Slaghekke","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. M.","family":"Middeldorp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. J.","family":"Klumper","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Lopriore","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Oepkes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,9,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62419-8"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.05.025"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.07.046"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8922"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2011.07.006"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(00)00440-1"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000106344"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181d57335"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2005.06.004"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000053890"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.01.067"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032597"},{"key":"e_1_2_6_14_1","first-page":"107","article-title":"Twin\u2010to\u2010twin transfusion syndrome (TTTS)","volume":"39","author":"Baschat A","year":"2011","journal-title":"J Perinat Med"},{"key":"e_1_2_6_15_1","first-page":"623","article-title":"Morbidity associated with prenatal disruption of the dividing membrane in twin gestations","volume":"78","author":"Gilbert WM","year":"1991","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1117\/1.JBO.17.6.068005"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1157"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2006.03.005"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-012-0372-2"},{"key":"e_1_2_6_20_1","first-page":"196","article-title":"Prognostic predictors of neurodevelopmental outcome or mortality in very\u2010low\u2010birth\u2010weight infants","volume":"46","author":"Chen PC","year":"2005","journal-title":"Acta Paediatr Taiwan"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1047"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.13445","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.13445","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T04:29:58Z","timestamp":1696480198000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.13445"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9,22]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2014,11]]}},"alternative-id":["10.1002\/uog.13445"],"URL":"https:\/\/doi.org\/10.1002\/uog.13445","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9,22]]},"assertion":[{"value":"2014-04-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-06-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-09-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}