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Fetoscopic Laser for Twin-to-Twin Transfusion Syndrome

Selective laser coagulation of vascular anastomoses on the monochorionic placenta in TTTS.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Fetoscopic Laser for Twin-to-Twin Transfusion Syndrome?

TTTS is characterized by net blood transfer from the donor to the recipient twin through arterio-venous vascular connections in the placenta in monochorionic diamniotic twins. Quintero staging (I–V) guides treatment.

Fetoscopic selective laser coagulation is the cauterization of placental vascular anastomoses by intrauterine endoscopy. Compared with older techniques, the Solomon technique reduces residual anastomoses and complications.

The optimal timing of surgery is between weeks 16 and 26. Center experience and a multidisciplinary fetal medicine team directly affect outcomes. Postoperative follow-up includes fetal echocardiography and neurological monitoring.

Symptoms

Sudden polyhydramnios–oligohydramnios discordance
Growth discordance (>20%)
'Stuck twin' appearance in the donor
Hydrops in the recipient twin
Abnormal umbilical cord and ductus venosus flow
Signs of fetal heart failure

Risk Factors

Monochorionic diamniotic twinning
Placental vascular anastomoses
Advanced maternal age in twin pregnancy
Late-stage TTTS diagnosis
Quintero stage III–IV
Fetal heart failure

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Polyhydramnios–oligohydramnios in a twin pregnancy
  • Detection of growth discordance
  • Abnormal Doppler findings
  • Referral to a center selected for fetoscopic laser

Treatment Methods

01
Multidisciplinary fetal medicine team evaluation
02
Fetoscopic selective laser (Solomon technique)
03
Amnioreduction (selected cases)
04
Postoperative fetal echocardiography
05
Magnesium sulfate and tocolysis
06
Close antenatal Doppler follow-up

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.