+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Fetoscopic laser ablation of placental anastomoses in twin-twin transfusion syndrome using 'Solomon technique'



Fetoscopic laser ablation of placental anastomoses in twin-twin transfusion syndrome using 'Solomon technique'



Ultrasound in Obstetrics and Gynecology 42(4): 434-439



To document perinatal outcomes following use of the 'Solomon technique' in the selective photocoagulation of placental anastomoses for severe twin-twin transfusion syndrome (TTTS). Between January 2010 and July 2012, data were collected from 102 consecutive monochorionic twin pregnancies complicated by severe TTTS that underwent fetoscopic laser ablation at four different centers. We compared outcomes between subjects that underwent selective laser coagulation using the Solomon technique (cases) and those that underwent selective laser coagulation without this procedure (controls). Of the 102 pregnancies examined, 26 (25.5%) underwent the Solomon technique and 76 (74.5%) did not. Of the 204 fetuses, 139 (68.1%) survived up to 30 days of age. At least one twin survived in 82 (80.4%) pregnancies and both twins survived in 57 (55.9%) pregnancies. When compared with the control group, the Solomon-technique group had a significantly higher survival rate for both twins (84.6 vs 46.1%; P < 0.01) and a higher overall neonatal survival rate (45/52 (86.5%) vs 94/152 (61.8%); P < 0.01). Use of the Solomon technique remained independently associated with dual twin survival (adjusted odds ratio (aOR), 11.35 (95% CI, 3.11-53.14); P = 0.0007) and overall neonatal survival rate (aOR, 4.65 (95% CI, 1.59-13.62); P = 0.005) on multivariable analysis. There were no cases of recurrent TTTS or twin anemia-polycythemia sequence (TAPS) in the Solomon-technique group. Use of the Solomon technique following selective laser coagulation of placental anastomoses appears to improve twin survival and may reduce the risk of recurrent TTTS and TAPS. Our data support the idea of performing a randomized controlled trial to evaluate the effectiveness of the Solomon technique.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 053233235

Download citation: RISBibTeXText

PMID: 23616360

DOI: 10.1002/uog.12492


Related references

Fetoscopic laser ablation of the placental anastomoses in twin-twin transfusion syndrome using the “Solomon technique. 2013

Outcome after fetoscopic selective laser ablation of placental anastomoses vs equatorial laser dichorionization for the treatment of twin-to-twin transfusion syndrome. American Journal of Obstetrics and Gynecology 209(3): 234.E1-8, 2013

P07.20: Peri-operative changes in fetal cardiac function with fetoscopic laser ablation of placental anastomoses in twin-to-twin transfusion syndrome. Ultrasound in Obstetrics & Gynecology 44(S1): 225-226, 2014

Outcome after fetoscopic selective laser ablation of placental anastomoses versus equatorial laser dichorionization for the treatment of Twin-to-Twin Transfusion Syndrome. 2013

Fetal cardiac function in recipient twins undergoing fetoscopic laser ablation of placental anastomoses for Stage IV twin-twin transfusion syndrome. Ultrasound in Obstetrics and Gynecology 42(1): 64-69, 2013

Elevated cell-free fetal DNA in maternal plasma after fetoscopic laser ablation of placental vascular anastomoses in twin-twin transfusion syndrome. American Journal of Obstetrics & Gynecology 189(6 Suppl.): S219, 2003

Pseudoamniotic Band Syndrome After Fetoscopic Laser Ablation of Placental Anastomoses for Twin-Twin Transfusion Syndrome: Two Case Reports and Systematic Review. Journal of Ultrasound in Medicine 36(11): 2373-2377, 2017

Fetal Cardiac Function In Recipient Twins Undergoing Fetoscopic Laser Ablation Of Placental Anastomoses For Stage Iv Twin-Twin Transfusion Syndrome TTTS. Ultrasound in Obstetrics & Gynecology 42(1): n/a-n/a, 2013

Isolated Ascites in a Monochorionic Twin after Fetoscopic Laser Ablation Is Not Necessarily Secondary to Recurrence or Anaemia: Bowel Complications in Twin-to-Twin Transfusion Syndrome after Fetoscopic Laser Ablation. Fetal Diagnosis and Therapy 45(5): 285-294, 2019

Selective fetoscopic laser photocoagulation of superficial placental anastomoses for the treatment of severe twin-twin transfusion syndrome. Clinics 64(2): 91-96, 2009

Placental vascular anastomoses visualized during fetoscopic laser surgery in severe mid-trimester twin-twin transfusion syndrome. Placenta 22(10): 876-881, 2001

Changes in umbilical venous volume flow after fetoscopic laser occlusion of placental vascular anastomoses in twin-to-twin transfusion syndrome. American Journal of Obstetrics and Gynecology 203(5): 479.E1-6, 2010

Impact of selective laser ablation of placental anastomoses on the cardiovascular pathology of the recipient twin in severe twin-twin transfusion syndrome. American Journal of Obstetrics and Gynecology 195(5): 1388-1395, 2006

Fetoscopic laser ablation of placental vessels in severe previable twin-twin transfusion syndrome. American Journal Of Obstetrics & Gynecology. 172(4 Part 1): 1202-1211, 1995

Severe twin-twin transfusion syndrome: outcome after fetoscopic laser ablation of the placental vascular equator. Bjog 114(6): 689-693, 2007