期刊
FETAL DIAGNOSIS AND THERAPY
卷 31, 期 1, 页码 1-9出版社
KARGER
DOI: 10.1159/000331165
关键词
Acardiac twin; Fetal therapy; Laser coagulation; Obstructive uropathy; Premature rupture of membrane; Twin-twin transfusion syndrome; Lower urinary tract obstruction; Twin-reversed arterial perfusion; Laser ablation; Fetal shunt; Cord occlusion
资金
- European Commission [LSHC-CT-2006-037409, CT2005 019707]
- Marie Curie Reintegration Grant [PERG07-GA-2010-268330]
- Flemish Regional Government [IWT/070715]
Objective: Iatrogenic preterm prelabor rupture of membranes (iPPROM; <37 weeks of gestation) is a major complication of fetal surgery. Little information is available about risk factors and incidence. Methods: We systematically reviewed reported iPPROM rates, gestational age at delivery and fetal survival after representative minimally invasive antenatal procedures. Results: A total of 1,146, 36 and 194 cases with mean iPPROM rates of 27, 31 and 26% were included for placental laser in twin-twin transfusion syndrome, shunting in lower urinary tract obstruction and interventions for twin-reversed arterial perfusion, respectively. In the statistical analysis, the maximum diameter of the instrument predicted iPPROM rate and was significantly related to gestational age at birth as well as fetal survival. Information on duration of the respective procedures was scarce and did not allow for meaningful analysis. Conclusions: iPPROM occurs in about 30% of cases treated by minimally invasive fetal surgery. The maximum diameter of the instrument explains iPPROM rate, gestational age at birth and fetal survival. Great variations in the reporting of iPPROM make data analysis difficult. Copyright (C) 2011 S. Karger AG, Basel
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