Fetoscopic Selective Laser Photocoagulation in Twin-Twin Transfusion Syndrome
Twin to Twin Transfusion Syndrome
About this trial
This is an interventional treatment trial for Twin to Twin Transfusion Syndrome focused on measuring twin to twin transfusion syndrome, fetoscopic selective laser photocoagulation, amnioreduction
Eligibility Criteria
Inclusion Criteria: Both twins are alive TTTS diagnosed prior to 22 weeks gestation Monochorionic diamniotic gestation Like sex twins Single placental mass Thin intertwin membrane Oligohydramnios in donor twin (deepest vertical pocket of ≤ 2 cm) Polyhydramnios with deepest vertical pocket of > 8 cm with or without Doppler or echocardiographic changes in the recipient twin (deepest vertical pocket of > 6 cm if previous amnioreduction) Decompressed bladder in donor not seen to fill during the ultrasound examination (stage II, III, or IV), unless Doppler velocimetry changes (absent end-diastolic umbilical artery flow, abnormal ductus venosus waveform), and/or echocardiographic changes (valvular insufficiency, ventricular hypertrophy) are already present No associated structural abnormalities No sonographic evidence of CNS injury at time of entry No preterm labor No maternal medical contraindication to anesthesia or surgery Exclusion Criteria: Failure to meet all inclusion criteria TTTS presenting after 22 weeks gestation Randomization after 24 weeks gestation Cervical length < 2.0 cm post initial Presence of cervical cerclage Uterine anomaly Refusal to accept randomization Unable to pursue prenatal care at an approved center coordinated by one of the participating institutions Unable to pursue postnatal evaluation at a NICHD Neonatal Research Network Institution
Sites / Locations
- University of California-San Francisco
- Evanston Northwestern Healthcare
- New York University School of Medicine
- Columbia-Presbyterian Medical Center
- Good Samaritan Hospital
- Cincinnati Children's Hospital Medical Center
- Children's Hospital of Philadelphia
- Magee-Women's Hospital
- University of Texas Medical Branch
- University of Utah Hospital
- Eastern Virginia Medical School
- University of Washington Medical Center