{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:21:10Z","timestamp":1792758070018,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2022,12]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To ascertain maternal and perinatal outcomes of monochorionic twin pregnancies complicated by twin\u2013twin transfusion syndrome (TTTS) treated with the Solomon technique compared with selective fetoscopic laser photocoagulation (SFLP) of placental anastomoses.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n MEDLINE, EMBASE and The Cochrane Library were searched to identify relevant studies. The outcomes observed were perinatal loss and survival, preterm prelabor rupture of membranes (PPROM), preterm birth (PTB), gestational age (GA) at delivery, interval between laser treatment and delivery, maternal bleeding, septostomy or chorioamniotic separation, placental abruption, twin anemia\u2013polycythemia sequence (TAPS), recurrence of TTTS, neonatal morbidity and neurological morbidity. Random\u2010effects head\u2010to\u2010head meta\u2010analyses were used to analyze the data. Pooled odds ratios (OR) and mean differences (MD) and their 95%\u2009CIs were calculated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Nine studies were included in the systematic review. There was generally no difference in the main maternal and pregnancy characteristics between pregnancies treated using the Solomon technique and those treated using SFLP of placental anastomoses. The risks of fetal loss (pooled OR, 0.69 (95%\u2009CI, 0.50\u20130.95);\n P<\/jats:italic>\n \u2009=\u20090.023), neonatal death (pooled OR, 0.37 (95%\u2009CI, 0.16\u20130.84);\n P<\/jats:italic>\n \u2009=\u20090.018) and perinatal loss (pooled OR, 0.56 (95%\u2009CI, 0.38\u20130.83);\n P<\/jats:italic>\n \u2009=\u20090.004) were significantly lower in pregnancies treated using the Solomon technique than in those treated with SFLP. Likewise, pregnancies treated using the Solomon technique had a significantly higher chance of survival of at least one twin (pooled OR, 2.31 (95%\u2009CI, 1.03\u20135.19);\n P<\/jats:italic>\n \u2009=\u20090.004) and double survival (pooled OR, 2.18 (95%\u2009CI, 1.29\u20133.70);\n P<\/jats:italic>\n \u2009=\u20090.001). There was no difference in the risk of PPROM (\n P<\/jats:italic>\n \u2009=\u20090.603), PPROM within 10\u2009days from laser surgery (\n P<\/jats:italic>\n \u2009=\u20090.982), PTB (\n P<\/jats:italic>\n \u2009=\u20090.207), maternal bleeding (\n P<\/jats:italic>\n \u2009=\u20090.219), septostomy or chorioamniotic separation (\n P<\/jats:italic>\n \u2009=\u20090.224) or chorioamnionitis (\n P<\/jats:italic>\n \u2009=\u20090.135) between the two groups, while the risk of placental abruption was higher in pregnancies treated using the Solomon technique (pooled OR, 2.90 (95%\u2009CI, 1.55\u20135.44);\n P<\/jats:italic>\n \u2009=\u20090.001). In the Solomon technique group, pregnancies delivered at a significantly earlier GA than did those treated with SFLP (pooled MD, \u20130.625\u2009weeks (95%\u2009CI, \u20130.90 to \u20130.35\u2009weeks);\n P<\/jats:italic>\n \u2009<\u20090.001), while there was no difference in the interval between laser treatment and delivery (\n P<\/jats:italic>\n \u2009=\u20090.589). The rate of recurrence of TTTS was significantly lower in pregnancies undergoing the Solomon technique (pooled OR, 0.43 (95%\u2009CI, 0.22\u20130.81);\n P<\/jats:italic>\n \u2009<\u20090.001), while there was no difference in the risk of TAPS between the two groups (\n P<\/jats:italic>\n \u2009=\u20090.792). Finally, there was no difference in the overall risk of neonatal morbidity (\n P<\/jats:italic>\n \u2009=\u20090.382) or neurological morbidity (\n P<\/jats:italic>\n \u2009=\u20090.247) between the two groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Monochorionic twin pregnancies complicated by TTTS undergoing laser treatment using the Solomon technique had a significantly higher survival rate and lower recurrence rate of TTTS but were associated with an increased risk of placental abruption and earlier GA at delivery compared to those treated with SFLP. \u00a9 2022 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/uog.26095","type":"journal-article","created":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T17:42:27Z","timestamp":1665769347000},"page":"731-738","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Solomon technique\n vs<\/i>\n selective fetoscopic laser photocoagulation for twin\u2013twin transfusion syndrome: systematic review and meta\u2010analysis of maternal and perinatal outcomes"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7546-8025","authenticated-orcid":false,"given":"F.","family":"D'Antonio","sequence":"first","affiliation":[{"name":"Center for Fetal Care and High\u2010Risk Pregnancy University of Chieti Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Herrera","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine Department, Colsanitas Clinic Colombian University Clinic\u00a0\u2013\u00a0Pediatric Clinic Bogota Colombia"},{"name":"Maternal Fetal Medicine Foundation, Fetal Health Foundation Bogota Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Oronzii","sequence":"additional","affiliation":[{"name":"Center for Fetal Care and High\u2010Risk Pregnancy University of Chieti Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2802-7670","authenticated-orcid":false,"given":"A.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London London UK"},{"name":"Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London London UK"},{"name":"Fetal Medicine Unit, Liverpool Women's Hospital University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,1]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"e131","article-title":"Society for Maternal\u2013Fetal Medicine. 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