Am J Perinatol 2013; 30(01): 005-010
DOI: 10.1055/s-0032-1322513
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Survival Outcomes of Twin–Twin Transfusion Syndrome Stage I: A Systematic Review of Literature

A. Cristina Rossi
1   Clinic of Obstetrics and Gynecology, University of Bari, Bari, Italy
,
Vincenzo D'Addario
1   Clinic of Obstetrics and Gynecology, University of Bari, Bari, Italy
› Institutsangaben
Weitere Informationen

Publikationsverlauf

10. Februar 2012

15. März 2012

Publikationsdatum:
26. Juli 2012 (online)

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Abstract

Objective To review literature about treatment of twin–twin transfusion syndrome (TTTS) stage I.

Materials A search in PubMed, EMBASE, Medline, and reference lists was performed. Inclusion criteria were TTTS diagnosed with standard criteria and classified with Quintero staging and survival rates (SR) stratified for stage and first-choice treatment. Outcomes were SR and progression to advanced stages. Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed.

Results Seven articles pooled 262 twin sets treated with amnioreduction (16%), conservative management (22%), and laser therapy (62%). The overall SR was 77% after amnioreduction, 86% in the conservative management group, and 85% in the laser therapy group. Progression rate occurred in 30%, 15%, and 0%, respectively. Outcomes were similar between laser therapy as first- versus second-choice treatment. Because most studies were observational and not comparative, a meta-analysis was not performed.

Conclusion Conservative management of TTTS stage I is a reasonable option until randomized clinical trials are presented.

Note

This review was presented by the first author to the First World Conference in Pediatrics and Obstetrics/Gynecology, OMICS group, Philadelphia, Pennsylvania (December 6 to 8, 2011) as oral presentation.