PDF(Pubmed)
Abstract：
Introduction: This study aimed to evaluate the effectiveness of selective laser photocoagulation of communicating vessels (SLPCV) on cardiac function in twins with twin-to-twin transfusion syndrome (TTTS). Methods: This retrospective cohort study evaluated 178 women with twin pregnancies complicated with TTTS and scheduled for SLPCV between 16 and 26 weeks of gestation. The severity of TTTS was determined by Quintero staging and the severity of cardiovascular disorders by the CHOP (Children\'s Hospital of Philadelphia) score. Patient survival was evaluated through a one-month-after-birth follow-up of fetuses. Results: The study revealed significant improvements in Doppler indices in both donors and recipients after SLPCV. The CHOP score also significantly decreased after the intervention. One-month-after-birth survival rates were 55.1% in donors and 56.7% in recipients. Some Doppler indexes of fetuses before SLPCV could predict survival until one month after birth. Conclusion: The study suggests that SLPCV can improve cardiac function in fetuses with TTTS and that some Doppler indexes can predict survival outcomes. Additionally, the severity of TTTS can be a powerful indicator of the severity of cardiovascular complications.
摘要：
简介：本研究旨在评估选择性通信血管激光光凝（SLPCV）对双胞胎双胞胎对双胞胎输血综合征（TTTS）的心功能的有效性。方法：这项回顾性队列研究评估了178例双胎妊娠合并TTTS并计划在妊娠16至26周进行SLPCV的妇女。TTTS的严重程度由Quintero分期确定，心血管疾病的严重程度由CHOP（费城儿童医院）评分确定。通过出生后一个月的胎儿随访评估患者的生存率。结果：研究显示SLPCV后供体和受体的多普勒指数均有显着改善。干预后CHOP评分也显著下降。捐献者出生后一个月的生存率为55.1％，接受者为56.7％。SLPCV之前胎儿的一些多普勒指数可以预测存活到出生后一个月。结论：本研究表明，SLPCV可以改善TTTS胎儿的心功能，并且某些多普勒指数可以预测生存结局。此外,TTTS的严重程度可以成为心血管并发症严重程度的有力指标。
