• David Baud, Rory Windrim, Johannes Keunen, Edmond N Kelly, Prakesh Shah, Tim van Mieghem, Seaward P Gareth R PG, and Greg Ryan.
• Fetal Medicine Unit, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
• Am. J. Obstet. Gynecol. 2013 Mar 1; 208 (3): 197.e1-7.

ObjectiveThe purpose of this study was to compare perinatal outcomes of pregnancies that undergo "early" (<17 weeks' gestation) or "late" (>26 weeks' gestation) fetoscopic laser ablation of placental vascular anastomoses for twin-twin transfusion syndrome (TTTS) with "conventional" cases that were treated at 17-26 weeks' gestation.Study DesignWe conducted a single center, retrospective analysis of 325 consecutive pregnancies that underwent fetoscopic laser therapy for severe TTTS.ResultsTwenty-four "early," 18 "late," and 283 "conventional" pregnancies with severe TTTS underwent laser therapy. Fetoscopy duration, gestation at delivery, survival rate, and complications were comparable among groups, except for preterm premature rupture of membranes at <7 days after laser therapy, which was more common in the "early" group than in either of the other 2 groups.ConclusionLaser therapy for TTTS at <17 or >26 weeks' gestation has similar outcomes to procedures done at 17-26 weeks' gestation. We suggest that conventional gestational age guidelines of 16-26 weeks for laser therapy for TTTS should be reevaluated.Copyright © 2013 Mosby, Inc. All rights reserved.

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