Introduction: This study aimed to investigate the risk factors, incidence, and influence on the perinatal outcome of chorioamniotic membrane separation (CMS) after fetoscopic laser photocoagulation (FLP). Material and Methods: This retrospective study included 312 women who underwent FLP for twin-to-twin transfusion syndrome (TTTS). Clinical records were used to review obstetrical examinations, complications, operative data, ultrasonographic findings, and perinatal and neonatal follow-up data in all patients. Results: A total of 260 cases of TTTS were analyzed. The incidence of CMS was 12.7% (33 cases). The only independent risk factor of CMS was performing FLP before 20 weeks of gestational age (GA) (odds ratio = 3.38 [1.44-7.93], p = 0.005). Concerning perinatal outcome, CMS was only related with increased risk of premature rupture of membranes (PROM) before 32 weeks (33.3 vs. 13.9%, p = 0.005), with no differences in GA at delivery and survival rate. Discussion: In our cohort, the incidence of CMS after FLP was approximately 13%, with surgery before 20 weeks being the only risk factor identified. Although in our population CMS did not worsen perinatal outcome in terms of preterm delivery or survival, the preterm PROM rate was increased and this should be considered for the patients' management.
The circulatory physiology of fetuses differs from that of neonates. The concept of biventricular combined cardiac output is necessary to understand and assess the fetal cardiac function. Fetal cardiac function has been estimated using echocardiographic methods such as M‐mode, B‐mode and pulsed wave Doppler. In addition, recent studies have reported the utility of tissue Doppler imaging in fetal echocardiography. However, parameters for fetal cardiac function remain to be established. Recently, we developed two novel techniques for assessing fetal cardiac function: an automatic fractional shortening method and E/e′ determination using the dual‐gate Doppler method. These two techniques are expected to be reliable and useful for assessing the fetal status in various pathological conditions.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.