{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T15:37:47Z","timestamp":1784302667507,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,2,4]],"date-time":"2016-02-04T00:00:00Z","timestamp":1454544000000},"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 & Gyne"],"published-print":{"date-parts":[[2016,3]]},"abstract":"ABSTRACT<\/jats:title>Objective<\/jats:title>To evaluate the incidence of chorioamniotic membrane separation (CMS<\/jats:styled-content>) after fetoscopy in monochorionic diamniotic (MCDA<\/jats:styled-content>) twins and its impact on pregnancy outcome.<\/jats:p><\/jats:sec>Methods<\/jats:title>The study group comprised a consecutive series of 338 women with an MCDA<\/jats:styled-content> pregnancy complicated by twin\u2013twin transfusion syndrome (TTTS<\/jats:styled-content>) or selective intrauterine growth restriction (sIUGR<\/jats:styled-content>) treated with selective laser photocoagulation of communicating vessels (SLPCV<\/jats:styled-content>) or cord occlusion (CO<\/jats:styled-content>). Data obtained included cervical length, gestational age at procedure, type and duration of surgery and placental location. The incidence of CMS<\/jats:styled-content>, the rates of miscarriage and preterm prelabor rupture of membranes (PPROM<\/jats:styled-content>), gestational age at delivery and neonatal survival were recorded.<\/jats:p><\/jats:sec>Results<\/jats:title>Of the study population of MCDA<\/jats:styled-content> pregnancies, 270 (79.9%) had TTTS<\/jats:styled-content> and 68 (20.1%) had sIUGR<\/jats:styled-content>. SLPCV<\/jats:styled-content> was performed in 252 (74.6%) cases and CO<\/jats:styled-content> in 86 (25.4%). Postoperative CMS<\/jats:styled-content> was observed in 70 (20.7%) cases. Patients with CMS<\/jats:styled-content> had higher rates of miscarriage (14.3% vs<\/jats:italic> 7.1%; P<\/jats:italic>\u2009=\u20090.049), PPROM<\/jats:styled-content> before 32\u2009weeks (43.3% vs<\/jats:italic> 13.7%; P<\/jats:italic>\u2009<\u20090.001) and preterm delivery before 32\u2009weeks (53.3% vs<\/jats:italic> 26.1%; P<\/jats:italic>\u2009<\u20090.001) and a lower rate of neonatal survival of at least one twin (81.7% vs<\/jats:italic> 93.6%; P<\/jats:italic>\u2009=\u20090.003). Multivariate analysis showed that gestational age at surgery was the only independent predictor, with the highest proportion of CMS<\/jats:styled-content> occurring in cases that underwent surgery before 18\u2009weeks' gestation (odds ratio, 2.941 (95%\u2009CI<\/jats:styled-content>, 1.640\u20135.275); P<\/jats:italic>\u2009<\u20090.001). There was no influence of cervical length, placental location, duration of surgery or type of surgery on the risk of CMS<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>CMS<\/jats:styled-content> complicated one\u2010fifth of all MCDA<\/jats:styled-content> pregnancies that underwent fetoscopy. It appeared to be more common in those who underwent surgery before 18\u2009weeks' gestation and was associated with poorer outcomes. Copyright \u00a9 2015 ISUOG. Published by John Wiley & Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.14936","type":"journal-article","created":{"date-parts":[[2015,7,3]],"date-time":"2015-07-03T16:06:51Z","timestamp":1435939611000},"page":"345-349","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Chorioamniotic membrane separation after fetoscopy in monochorionic twin pregnancy: incidence and impact on perinatal outcome"],"prefix":"10.1002","volume":"47","author":[{"given":"J. U.","family":"Ortiz","sequence":"first","affiliation":[{"name":"BCNatal \u2010 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), IDIBAPS University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER) Barcelona Spain"},{"name":"Frauenklinik und Poliklinik Technische Universit\u00e4t M\u00fcnchen Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Eixarch","sequence":"additional","affiliation":[{"name":"BCNatal \u2010 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), IDIBAPS University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Peguero","sequence":"additional","affiliation":[{"name":"BCNatal \u2010 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), IDIBAPS University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. M.","family":"Lobmaier","sequence":"additional","affiliation":[{"name":"BCNatal \u2010 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), IDIBAPS University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER) Barcelona Spain"},{"name":"Frauenklinik und Poliklinik Technische Universit\u00e4t M\u00fcnchen Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Bennasar","sequence":"additional","affiliation":[{"name":"BCNatal \u2010 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), IDIBAPS University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M.","family":"Martinez","sequence":"additional","affiliation":[{"name":"BCNatal \u2010 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), IDIBAPS University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Gratac\u00f3s","sequence":"additional","affiliation":[{"name":"BCNatal \u2010 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), IDIBAPS University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER) Barcelona 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