{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:15:36Z","timestamp":1779167736359,"version":"3.51.4"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,8,11]],"date-time":"2015-08-11T00:00:00Z","timestamp":1439251200000},"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":["BJOG"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The introduction of fetoscopic laser surgery of placental anastomoses has led to a significant improvement of perinatal outcome of twin pregnancies affected by twin\u2010to\u2010twin\u2010transfusion syndrome (TTTS). To quantify the perinatal outcome and neurological morbidity in triplet pregnancies complicated by TTTS, which were treated with fetoscopic laser surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>Medline, <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>mbase, <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>inahl and <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ochrane were searched.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>The outcomes observed were: fetal and perinatal survival, preterm birth and abnormal neurological outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Two authors reviewed all abstracts independently. Meta\u2010analyses of proportions were used to combine data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Eight studies (126 triplet pregnancies, 104 dichorionic\u2010triamniotic [<jats:styled-content style=\"fixed-case\">DCTA<\/jats:styled-content>] and 22 monochorionic\u2010triamniotic [<jats:styled-content style=\"fixed-case\">MCTA<\/jats:styled-content>]) treated with fetoscopic laser surgery were included in this review. In <jats:styled-content style=\"fixed-case\">DCTA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">MCTA<\/jats:styled-content> pregnancies, fetal losses were 18.9% and 28.9%, respectively; perinatal losses were 23.6% and 75.0%; preterm births &lt;28\u00a0weeks of gestation were 16.9% and 37.1%; preterm births &lt;32\u00a0weeks of gestation were\u00a050.0% and 69.5%; at least one fetus survived in 95.4% and 88.9% of the pregnancies; at least two fetuses survived in 81.8% and 68.3% of the pregnancies; and in 55.9% and 48.4% pregnancies all triplets survived. Finally, the incidence of abnormal neurological outcomes ranged from 0 to 37% in <jats:styled-content style=\"fixed-case\">DCTA<\/jats:styled-content> and from 0 to 50% in <jats:styled-content style=\"fixed-case\">MCTA<\/jats:styled-content> triplets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both <jats:styled-content style=\"fixed-case\">DTCA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">MCTA<\/jats:styled-content> triplet pregnancies affected by <jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content> are at high risk of adverse perinatal outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Both <jats:styled-content style=\"fixed-case\">DTCA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">MCTA<\/jats:styled-content> triplet pregnancies affected by <jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content> are at high risk of adverse perinatal outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13553","type":"journal-article","created":{"date-parts":[[2015,8,12]],"date-time":"2015-08-12T06:15:03Z","timestamp":1439360103000},"page":"328-336","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Perinatal outcome after fetoscopic laser surgery for twin\u2010to\u2010twin transfusion syndrome in triplet pregnancies"],"prefix":"10.1111","volume":"123","author":[{"given":"F","family":"D'Antonio","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit Division of Developmental Sciences St George's University of London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Thilaganathan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Division of Developmental Sciences St George's University of London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Toms","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Division of Developmental Sciences St George's University of London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Manzoli","sequence":"additional","affiliation":[{"name":"Department of Medicine and Aging Sciences University of Chieti Chieti Italy"},{"name":"CeSI Biotech Chieti Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Bhide","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Division of Developmental Sciences St George's University of London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Papageorghiou","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Division of Developmental Sciences St George's University of London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Khalil","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Division of Developmental Sciences St George's University of London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,8,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/del048"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000356170"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.03.050"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2006.11.002"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032597"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5328"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.10.880"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.05.036"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1797.2010.01380.x"},{"key":"e_1_2_7_11_1","volume-title":"Systematic Reviews: CRD's Guidance for Undertaking Reviews in Health Care","author":"NHS Centre for Reviews and Dissemination","year":"2009"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-149-12-200812160-00008"},{"key":"e_1_2_7_13_1","first-page":"8.e83138","article-title":"Evaluation of theendorsement of the preferred reporting items for systematic reviews and meta\u2010analysis (PRISMA) statement on the quality of published systematic review and meta\u2010analyses","author":"Panic N","year":"2013","journal-title":"PLoS One"},{"key":"e_1_2_7_14_1","unstructured":"WellsGA SheaB O'ConnellD PetersonJ WelchV LososM et\u00a0al.\u00a0Newcastle\u2010Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta\u2010analyses[www.ohri.ca\/programs\/clinical_epidemiology\/%20oxford.htm]. Accessed 17 February 2015."},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0024384"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2014.03.003"},{"key":"e_1_2_7_17_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2","author":"Higgins JPT","year":"2009"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4357"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13369"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000339651"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7328"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767050903177201"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1220789"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1829"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.06.039"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.06.018"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12363"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1159\/000341814"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318195873e"},{"key":"e_1_2_7_30_1","first-page":"1246","article-title":"Outcome for children born after in utero laser surgery therapy for severe twin\u2010to\u2010twin transfusion syndrome","volume":"108","author":"Sutcliffe AG","year":"2001","journal-title":"BJOG"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.07.040"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.13553","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.13553","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T04:41:44Z","timestamp":1696308104000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.13553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8,11]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2016,2]]}},"alternative-id":["10.1111\/1471-0528.13553"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.13553","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8,11]]},"assertion":[{"value":"2015-06-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-08-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}