{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:51:07Z","timestamp":1787071867637,"version":"build-2736575974"},"reference-count":31,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Fetal Diagn Ther"],"abstract":"<jats:p>Introduction: Approximately half of twin-to-twin transfusion syndrome (TTTS) cases are complicated by selective fetal growth restriction (sFGR). Although fetoscopic laser photocoagulation (FLP) is the standard treatment, perinatal outcomes in cases with concomitant sFGR \u2013 particularly according to single or dual fetal survival after laser \u2013 are not well established. The objective of this study was to compare post-FLP obstetrical and neonatal outcomes between TTTS+sFGR and isolated TTTS, with separate analyses in pregnancies with immediate single or dual fetal survival. Methods: This was a retrospective cohort study including all TTTS cases treated with FLP at a single institution between November 2011 and April 2023. TTTS was diagnosed according to Quintero criteria. sFGR was defined as an estimated fetal weight &lt;10th percentile in one twin with an inter-twin weight discordance \u226525% at the time of FLP. Outcomes included immediate post-FLP fetal demise (within 48 h after FLP), preterm premature rupture of membranes (PPROM), gestational age (GA) at delivery, and neonatal survival at birth and at 30 days, analyzed according to post-FLP single or dual fetal survival. Results: Among 424 cases, 188 (44.3%) had TTTS + sFGR. GA and cervical length at FLP were similar between groups, but TTTS+sFGR cases showed more severe disease, with a higher proportion of Quintero stage III. Dual fetal survival after FLP was lower in TTTS+sFGR compared with isolated TTTS (iTTTS; 79.6% vs. 88.5%). In pregnancies with single fetal survival post-FLP, TTTS+sFGR was associated with higher rates of delivery before 32 weeks (p = 0.03) and increased post-FLP PPROM (p = 0.03). Ex-donor fetuses in this group had significantly lower survival at birth and at 30 days compared with iTTTS. Even in cases with dual survival post-FLP, ex-donor survival at birth and at 30 days remained lower in TTTS + sFGR, while no other perinatal outcomes differed. Conclusion: When stratified by immediate single or dual post-FLP survival, pregnancies with TTTS complicated by sFGR showed consistently worse obstetrical and neonatal outcomes compared with isolated TTTS, particularly due to reduced ex-donor survival across both groups. Further studies are needed to elucidate the mechanisms underlying these findings.<\/jats:p>","DOI":"10.1159\/000553016","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T16:01:19Z","timestamp":1782403279000},"page":"1-9","source":"Crossref","is-referenced-by-count":0,"title":["Consequences of Selective Fetal Growth Restriction in Perinatal Outcomes after Fetoscopic Laser Photocoagulation for Twin-to-Twin Transfusion Syndrome, Based on Single or Dual Survival"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4950-036X","authenticated-orcid":false,"given":"Leticia","family":"Ben\u00edtez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8583-2054","authenticated-orcid":false,"given":"Romain","family":"Corroenne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0431-5280","authenticated-orcid":false,"given":"Jessian Louis","family":"Munoz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed 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