{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T17:09:34Z","timestamp":1780852174218,"version":"3.54.1"},"reference-count":21,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Col. Bras. Cir."],"abstract":"<jats:p>ABSTRACT  Introduction:  twin-to-twin transfusion syndrome (TTTS), defined by combination of polyhydramnios-oligohydramnios, is the most prevalent (5%-35%) of the abnormalities due to placental vascular anastomoses and the most lethal (80%-100% mortality) if untreated. Fetoscopic laser ablation of abnormal vasculature using the Solomon technique is the gold standard approach. It consists of interrupting the intertwin blood flow.  Objectives:  to present our initial experience at the Fetal Surgery Service of the Hospital de Clinicas of the Federal University of Parana (HC-UFPR) and to compare our results with those reported in the literature.  Methods:  we conducted a retrospective analysis of pregnancies who had undergone laser ablation, assessing data on Quintero\u2019s staging, gestational age at diagnosis and at the time of the procedure, placental position, immediate post-procedure survival, and survival after the neonatal period. We then compared these data with the most recent data available in the literature.  Results:  we analyzed ten TTTS cases. The diagnosis was performed before the 26th week of pregnancy (median 20.8 weeks) and treatment occurred in a median of 9.5 days later. The distribution by the Quintero\u2019s staging was of three cases in stage II, five in stage III, and two in stage IV. In 50% of the gestations, at least one of the fetuses survived through the neonatal period.  Conclusion:  the treatment of TTTS in the HC-UFPR had a positive impact in the survival of the affected fetuses, although the results were worse than the ones reported in the literature, probably due to the delay in referencing the patients to our service, leading to a prolonged interval between diagnosis and treatment.<\/jats:p>","DOI":"10.1590\/0100-6991e-20202671","type":"journal-article","created":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T14:38:47Z","timestamp":1611153527000},"source":"Crossref","is-referenced-by-count":2,"title":["Twin-twin transfusion syndrome - a University Hospital experience with intrauterine treatment"],"prefix":"10.1590","volume":"48","author":[{"given":"THAMYLE MODA DE SANTANA","family":"REZENDE","sequence":"first","affiliation":[{"name":"Federal University of Paran\u00e1,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9520-1187","authenticated-orcid":false,"given":"VIKTORIA","family":"WEIHERMANN","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CAMILA GIRARDI","family":"FACHIN","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RAFAEL FREDERICO","family":"BRUNS","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ANDR\u00c9 IVAN BRADLEY SANTOS","family":"DIAS","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2021]]},"reference":[{"issue":"1","key":"ref1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1159\/000020889","article-title":"Acardiac twins pathophysiology, diagnosis, outcome and treatment. Six cases and review of the literature","volume":"14","author":"S\u00f8gaard K","year":"1999","journal-title":"Fetal Diagn Ther"},{"issue":"1","key":"ref2","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.bpobgyn.2007.07.002","article-title":"Update on twin-to-twin transfusion syndrome","volume":"22","author":"El Kateb A","year":"2008","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"issue":"5","key":"ref3","doi-asserted-by":"crossref","first-page":"494.e1","DOI":"10.1016\/j.ajog.2009.01.048","article-title":"The pregnancy and long-term neurodevelopmental outcome of monochorionic diamniotic twin gestations: a multicenter prospective cohort study from the first trimester onward","volume":"200","author":"Ortibus E","year":"2009","journal-title":"Am J Obstet Gynecol"},{"key":"ref4","series-title":"Obstetr\u00edcia de Williams","author":"Cunningham FG","year":"2016","edition":"24"},{"issue":"1","key":"ref5","doi-asserted-by":"crossref","first-page":"57","DOI":"10.20513\/2447-6595.2015v55n1p57-60","article-title":"Restri\u00e7\u00e3o de crescimento seletiva em gesta\u00e7\u00e3o gemelar monocri\u00f4nica relato de caso","volume":"55","author":"Lima Filho PW","year":"2015","journal-title":"Revi Med UFC"},{"issue":"3","key":"ref6","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1017\/thg.2016.25","article-title":"Solomon technique versus selective coagulation for twin-twin transfusion syndrome","volume":"19","author":"Slaghekke F","year":"2016","journal-title":"Twin Res Hum Genet"},{"issue":"4","key":"ref7","doi-asserted-by":"crossref","first-page":"237","DOI":"10.2350\/13-03-1315-MISC.1","article-title":"What-and why-the pathologist should know about twin-to-twin transfusion syndrome","volume":"16","author":"De Paepe ME","year":"2013","journal-title":"Pediatr Dev Pathol"},{"issue":"1","key":"ref8","first-page":"E28","article-title":"N-terminal pro-brain natriuretic peptide levels in monochorionic diamniotic twins with twin-to-twin transfusion syndrome treated by fetoscopic laser photocoagulation","volume":"59","author":"Fujioka K","year":"2013","journal-title":"Kobe J Med Sci"},{"issue":"10","key":"ref9","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1136\/adc.57.10.781","article-title":"Feto-fetal transfusion syndrome","volume":"57","author":"Galea P","year":"1982","journal-title":"Arch Dis Child"},{"issue":"8","key":"ref10","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1038\/sj.jp.7200292","article-title":"Staging of twin-twin transfusion syndrome","volume":"19","author":"Quintero RA","year":"1999","journal-title":"J Perinatol"},{"issue":"3","key":"ref11","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1046\/j.1469-0705.2000.00272.x","article-title":"Sono-endoscopic delineation of the placental vascular equator prior to selective fetoscopic laser ablation in twin-to-twin transfusion syndrome","volume":"16","author":"Thilaganathan B","year":"2000","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"7","key":"ref12","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1002\/pd.2803","article-title":"Laser therapy for twin-to-twin transfusion syndrome (TTTS)","volume":"31","author":"Chalouhi GE","year":"2011","journal-title":"Prenatal diagnosis"},{"issue":"4","key":"ref13","first-page":"434","article-title":"Fetoscopic laser ablation of placental anastomoses in twin-twin transfusion syndrome using 'Solomon technique' Ultrasound Obstet","volume":"42","author":"Ruano R","year":"2013","journal-title":"Gynecol"},{"issue":"1","key":"ref14","first-page":"CD002073","article-title":"Interventions for the treatment of twin-twin transfusion syndrome","author":"Roberts D","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"issue":"10","key":"ref15","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1080\/14767050701591827","article-title":"Sequential selective laser photocoagulation of communicating vessels in twin-twin transfusion syndrome","volume":"20","author":"Quintero RA","year":"2007","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"6","key":"ref16","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1097\/01.AOG.0000161322.92539.23","article-title":"Contemporary treatments for twin-twin transfusion syndrome","volume":"105","author":"Fox C","year":"2005","journal-title":"Obstet Gynecol"},{"issue":"3","key":"ref17","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1017\/thg.2016.28","article-title":"Laser treatment of twin-to-twin transfusion syndrome","volume":"19","author":"Quintero R","year":"2016","journal-title":"Twin Res Hum Genet"},{"issue":"1","key":"ref18","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.ajog.2012.09.025","article-title":"The vascular anastomoses in monochorionic twin pregnancies and their clinical consequences","volume":"208","author":"Lewi L","year":"2013","journal-title":"Am J Obstet Gynecol"},{"issue":"55","key":"ref19","doi-asserted-by":"crossref","DOI":"10.3791\/3208","article-title":"Accurate and simple evaluation of vascular anastomoses in monochorionic placenta using colored dye","author":"Lopriore E","year":"2011","journal-title":"J Vis Exp"},{"issue":"1","key":"ref20","first-page":"33","article-title":"Complicaciones intestinales en el s\u00edndrome de trasfusi\u00f3n feto fetal (STFF)","volume":"30","author":"S\u00e1nchez-Gal\u00e1n A","year":"2017","journal-title":"Cir Pediatr"},{"issue":"6","key":"ref21","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1590\/S0100-72032009000600002","article-title":"Hist\u00f3ria natural das gesta\u00e7\u00f5es gemelares monocori\u00f4nicas diamni\u00f3ticas com e sem transfus\u00e3o feto-fetal","volume":"31","author":"Peralta CF","year":"2009","journal-title":"Rev Bras Ginecol Obstet"}],"container-title":["Revista do Col\u00e9gio Brasileiro de Cirurgi\u00f5es"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/rcbc\/v48\/0100-6991-rcbc-48-e20202671.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T12:04:21Z","timestamp":1611921861000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0100-69912021000100202&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":21,"alternative-id":["S0100-69912021000100202"],"URL":"https:\/\/doi.org\/10.1590\/0100-6991e-20202671","relation":{},"ISSN":["1809-4546","0100-6991"],"issn-type":[{"value":"1809-4546","type":"electronic"},{"value":"0100-6991","type":"print"}],"subject":[],"published":{"date-parts":[[2021]]},"article-number":"e20202671"}}