{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:44:21Z","timestamp":1787013861370,"version":"build-2736575974"},"reference-count":39,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T00:00:00Z","timestamp":1709078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Our objective was to investigate outcomes in twin\u2010to\u2010twin transfusion syndrome (TTTS) treated with fetoscopic laser surgery (FLS) at &lt;18\u2009weeks vs \u226518\u2009weeks, and to conduct subgroup analysis of TTTS with FLS\u2009at &lt;16\u2009weeks vs 16\u201318\u2009weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>PubMed, Scopus and Web of Science were searched systematically from inception until May 2023. Primary outcome was survival, and secondary outcomes included preterm premature rupture of membranes (PPROM), preterm birth and gestational age (GA) at delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine studies encompassing 1691 TTTS pregnancies were included. TTTS stage III was significantly more common in TTTS pregnancies treated with FLS at &lt;18\u2009weeks (odds ratio [OR] 2.84, 95% confidence interval [CI] 1.24\u20136.54), and procedure duration was shorter at &lt;18\u2009weeks (MD \u22125.27\u2009minutes, 95% CI \u22129.19 to \u22121.34). GA at delivery was significantly earlier in TTTS pregnancies treated with FLS at &lt;18\u2009weeks (MD \u22123.12\u2009weeks, 95% CI \u22126.11 to \u22120.13). There were no significant differences in outcomes, including PPROM, PPROM\u2009at &lt;7\u2009days post\u2010FLS, preterm birth at &lt;28 and &lt;32\u2009weeks, delivery at &lt;7\u2009days post\u2010FLS, and survival outcomes, including fetal demise, live birth and neonatal survival. Similarly, TTTS stage III was more common in TTTS with FLS at &lt;16\u2009weeks than at 16\u201318\u2009weeks (OR 2.95, 95% CI 1.62\u20135.35), with no significant differences in the aforementioned outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In early TTTS treated with FLS, outcomes were comparable between those treated at &lt;18\u2009weeks compared with \u226518\u2009weeks except for GA at delivery, which was 3\u2009weeks earlier. In the subset treated at &lt;16\u2009weeks vs 16\u201318\u2009weeks, the procedure was feasible without an increased risk of very early preterm birth or perinatal mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.14806","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T08:40:15Z","timestamp":1709109615000},"page":"824-831","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Perinatal outcomes following fetoscopic laser surgery for early twin\u2010to\u2010twin transfusion syndrome: Systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5611-1231","authenticated-orcid":false,"given":"Hiba J.","family":"Mustafa","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Indiana University School of Medicine  Indianapolis Indiana USA"},{"name":"The Fetal Center at Riley Children's and Indiana University Health  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faezeh","family":"Aghajani","sequence":"additional","affiliation":[{"name":"BCNatal Fetal Medicine Research Center, Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Patrick","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam M.","family":"Baerz","sequence":"additional","affiliation":[{"name":"School of Medicine Iran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Arias\u2010S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Unidad de Cuidados Intensivos Clinica Santa Ana  Cuenca 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