Perioperative risk factors of preterm delivery after fetoscopic laser photocoagulation for twin–twin transfusion syndrome

Abstract

AbstractObjectiveTo identify risk factors for preterm delivery (PTD) in patients who received fetoscopic laser photocoagulation (FLP) of placental anastomoses for twin–twin transfusion syndrome (TTTS).MethodsThis retrospective cohort study prospectively analyzed and recorded perioperative data in a cohort of patients who had FLP for TTTS, identifying perioperative risk factors for PTD using a Cox proportional hazard regression model.ResultsOf 304 patients included, 26 (8.6%) delivered within 4 weeks of FLP. Independent predictors of delivery within 4 weeks of FLP were a history of PTD (hazard ratio [HR]: 5.91, 95% confidence interval [CI]:1.21–28.82, p = 0.03), vaginal bleeding in the second trimester (HR: 6.62, 95% CI: 1.76–24.90, p < 0.01), and amnioreduction ≥1715 mL (HR: 3.16, 95% CI: 1.11–9.05, p < 0.03).ConclusionPatients with a history of PTD, preoperative vaginal bleeding, and amnioreduction ≥1715 mL were more likely to deliver prematurely.