Abstract：
To investigate the outcomes of asymptomatic stage I twin-to-twin transfusion syndrome (stage I TTTS) among patients treated with fetoscopic laser photocoagulation (FLP) versus expectant management. Databases such as PubMed, Web of Science and Scopus were systematically searched from inception up to March 1st, 2022. The primary outcome was at least one fetal survival at birth and secondary outcomes included gestational age at delivery, preterm premature rupture of membranes < 32 weeks, preterm birth < 32 weeks, and single and dual fetal survival. Five studies were included in the meta-analysis. There was no significant difference in terms of at least one survival (odds ratio (OR) = 1.40, 95%CI= (0.26, 7.43), P = 0.70), single survival (OR = 0.87, 95%CI= (0.51, 1.48), P = 0.60) and dual survival (OR = 1.63, 95%CI= (0.74, 3.62), P = 0.23) among FLP and expectant groups. Gestational age at delivery (mean difference = 1.19, 95%CI= (-0.25, 2.63), P = 0.10), the risk of PTB<32 weeks (OR = 0.88, 95%CI= (0.50, 1.54), P = 0.65), and pPROM<32 weeks (OR = 1.80, 95% CI= (0.41, 7.98), P = 0.44) were also comparable between the groups. Routine FLP of the placental anastomoses before 26 weeks of gestation is unlikely to be beneficial among asymptomatic stable stage I TTTS patients without cervical shortening as the procedure does not offer a survival advantage compared with expectant management.
摘要：
探讨无症状I期双对双输血综合征(I期TTTS)在胎儿镜激光光凝(FLP)与期待治疗患者中的转归。数据库，如PubMed、从成立到3月1日，对WebofScience和Scopus进行了系统搜索，2022年。主要结局是出生时至少有一个胎儿存活，次要结局包括分娩时的胎龄。早产胎膜早破<32周，早产<32周，以及单胎和双胎存活。5项研究纳入荟萃分析。至少一次生存没有显着差异（比值比（OR）=1.40，95CI=（0.26，7.43），P=0.70),单次生存（OR=0.87，95CI=（0.51，1.48），P=0.60）和双重生存率（OR=1.63，95CI=（0.74，3.62），FLP组和预期组之间的P=0.23）。分娩时的妊娠年龄（平均差=1.19，95CI=（-0.25，2.63），P=0.10),PTB的风险<32周（OR=0.88，95CI=（0.50，1.54），P=0.65),pPROM<32周(OR=1.80，95%CI=(0.41，7.98)，P=0.44）在两组之间也具有可比性。妊娠26周前胎盘吻合术的常规FLP在无症状的稳定I期TTTS患者中不太可能有益，因为与预期治疗相比，该手术没有生存优势。
