scholarly journals Endoscopic Placental Laser Coagulation in Monochorionic Diamniotic Twins with Type II Selective Fetal Growth Restriction

2015 ◽  
Vol 38 (2) ◽  
pp. 86-93 ◽  
Author(s):  
Gergana Peeva ◽  
Sarah Bower ◽  
Laszlo Orosz ◽  
Petya Chaveeva ◽  
Ranjit Akolekar ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Laser Surgery ◽  
Cervical Length ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Laser Coagulation ◽  
Multivariable Logistic Regression Analysis ◽  
Type Ii ◽  
Discharge From Hospital

Objective: To determine predictors of survival in monochorionic diamniotic twins with selective fetal growth restriction type II (sFGR-II), with or without twin-to-twin transfusion syndrome (TTTS), treated by endoscopic placental laser coagulation. Methods: Laser surgery was performed at 20 (15-27) weeks' gestation in 405 cases of sFGR-II with and 142 without coexisting TTTS. Multivariable logistic regression analysis was performed to determine significant predictors of survival to discharge from hospital. Results: There was survival of the small twin in 216 (39.5%) and of the large twin in 379 (69.3%) cases. Significant predictors of survival of both the small and larger twin were ductus venosus Doppler findings in the small twin, gestational age at laser and cervical length, but not the presence of TTTS or Doppler findings in the large twin. Conclusions: In sFGR-II, survival after laser surgery is primarily dependent on the condition of the small twin.

Endoscopic Placental Laser Coagulation in Dichorionic and Monochorionic Triplet Pregnancies

2016 ◽  
Vol 40 (3) ◽  
pp. 174-180 ◽  
Author(s):  
Gergana Peeva ◽  
Petya Chaveeva ◽  
Enrique Gil Guevara ◽  
Ranjit Akolekar ◽  
Kypros H. Nicolaides
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Laser Surgery ◽  
Survival Rates ◽  
Growth Restriction ◽  
Laser Coagulation ◽  
Endoscopic Laser ◽  
Combined Data

Objective: To report the outcome of monochorionic (MC) and dichorionic (DC) triamniotic (TA) triplet pregnancies treated with endoscopic laser coagulation of the communicating placental vessels for severe feto-fetal transfusion syndrome (FFTS) and selective fetal growth restriction (sFGR). Methods: Laser surgery was performed at 18 (15-24) weeks' gestation in 11 MCTA and 33 DCTA pregnancies complicated by FFTS and 14 DCTA pregnancies complicated by sFGR. Data from our study and previous reports were pooled using meta-analytic techniques. Results: Survival of at least one baby and survival among all fetuses was 97.0 and 72.7% in DCTA pregnancies with FFTS, 78.6 and 52.4% in DCTA pregnancies with sFGR and 81.8 and 39.4% in MCTA pregnancies with FFTS. In the combined data from our study and previous reports, the pooled survival rates in 132 DCTA pregnancies with FFTS were 94.4 and 76.1%, and in 29 MCTA pregnancies with FFTS, they were 80.6 and 57.5%. Conclusions: Survival after laser surgery is higher in DC triplets with FFTS than in those with sFGR and in DC than in MC triplets with FFTS.

scholarly journals OP11.04: A novel fetoscopic finding of poor prognosis in selective fetal growth restriction type II

2018 ◽  
Vol 52 ◽  
pp. 95-96
Author(s):  
E. Gil Guevara ◽  
R. Diaz ◽  
S. Chavez ◽  
F. Lim ◽  
J. Peiro
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Poor Prognosis ◽  
Growth Restriction ◽  
Type Ii

Hypercoiled cord can cause a reversible abnormal Doppler in ductus venosus in cases of fetal growth restriction

2018 ◽  
Author(s):  
Shigenori Iwagaki ◽  
Yuichiro Takahashi ◽  
Rika Chiaki ◽  
Kazuhiko Asai ◽  
Masako Matsui ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Ductus Venosus

scholarly journals Modern concepts of low birth weight and fetal growth restriction

2021 ◽  
Vol 102 (3) ◽  
pp. 347-354
Author(s):  
O V Yakovleva ◽  
I E Rogozhina ◽  
T N Glukhova
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Abdominal Circumference ◽  
Ductus Venosus ◽  
Management Algorithm ◽  
Pubmed Database ◽  
Single Standard

The aim of this work is to study the state of the problem of the development of small-for-gestational-age fetus and fetal growth restriction over the past 5 years. A review of randomized trials of the PubMed database for the period of 2015 to 2020 was carried out. Experts reached an agreement on the definition of diagnostic criteria for small-for-gestational-age fetus and fetal growth restriction, a clinically valid classification was created, and the main monitoring strategies were developed. Due to the different pathogenesis, fetal growth restriction is divided into early and late. The observation algorithm includes tests that have shown higher sensitivity and specificity. There is no single standard for the median weight and abdominal circumference of a fetus, indicators of the reference range for fetal Doppler. Smoking cessation and taking acetylsalicylic acid at a dose of 150 mg at high risk of preeclampsia is recommended to prevent the small-for-gestational-age fetus and fetal growth restriction. The pregnancy management algorithm includes Doppler ultrasound examination of the umbilical artery, cardiotocography. If this pathology occurs before 32 weeks of pregnancy, the blood flow in ductus venosus is additionally examined, and after 32 weeks of pregnancy, the middle cerebral artery blood velocities and cerebroplacental ratio are assessed. Indicators of Doppler velocimetry and cardiotocography, which serve as criteria for early termination of pregnancy, are developed, measures are proposed to improve neonatal outcomes prevention of respiratory distress syndrome at 2434 weeks of gestation, as well as magnesium therapy for fetal neuroprotection. The problems of preventing fetal growth restriction and the algorithm for monitoring pregnant women who do not have risk factors for small-for-gestational-age fetus, management tactics and indications for delivery while slowing fetal weight gain remain unresolved.

scholarly journals Twin-Twin Transfusion Syndrome with and without Selective Fetal Growth Restriction Prior to Fetoscopic Laser Surgery: Short and Long-Term Outcome

2019 ◽  
Vol 8 (7) ◽  
pp. 969 ◽  
Author(s):  
Groene ◽  
Tollenaar ◽  
van Klink ◽  
Haak ◽  
Klumper ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Laser Surgery ◽  
Growth Restriction ◽  
Separate Analysis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Short And Long Term ◽  
Perinatal Survival

As twin-twin transfusion syndrome (TTTS) and selective fetal growth restriction (sFGR) are both prevalent complications of monochorionic (MC) twin pregnancies, its coexistence is not uncommon. The aim of this study is to evaluate the short and long-term outcome in TTTS with and without sFGR prior to fetoscopic laser coagulation. All TTTS cases treated with laser surgery at our center between 2001–2019 were retrospectively reviewed for the presence of sFGR, defined as an estimated fetal weight (EFW) <10th centile. We compared two groups: TTTS-only and TTTS + sFGR. Primary outcomes were perinatal survival and long-term severe neurodevelopmental impairment (NDI). Of the 527 pregnancies eligible for analysis, 40.8% (n = 215) were categorized as TTTS-only and 59.2% (n = 312) as TTTS + sFGR. Quintero stage at presentation was higher in the TTTS + sFGR group compared to the TTTS-only group (57% compared to 44% stage III). Separate analysis of donors showed significantly lower perinatal survival for donors in the TTTS + sFGR group (72% (224/311) compared to 81% (173/215), p = 0.027). Severe NDI at follow-up in long-term survivors in the TTTS-only and TTTS + sFGR group was present in 7% (13/198) and 9% (27/299), respectively (p = 0.385). Both sFGR (OR 1.5;95% CI 1.1–2.0, p = 0.013) and lower gestational age at laser (OR 1.1;95% CI 1.0–1.1, p = 0.001) were independently associated with decreased perinatal survival. Thus, sFGR prior to laser surgery is associated with a more severe initial presentation and decreased donor perinatal survival. The long-term outcome was not affected.

scholarly journals P10.27: The size of the ductus venosus in fetal growth restriction

2005 ◽  
Vol 26 (4) ◽  
pp. 445-445
Author(s):  
J. Airoldi ◽  
D. C. Wood ◽  
A. Ness ◽  
E. Done ◽  
V. Berghella ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Ductus Venosus
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