To evaluate the incidence, risk factors and perinatal morbidity and mortality due to CA after TTTS treated with fetoscopic laser surgery.
ID
Source
Brief title
Condition
- Hepatobiliary neoplasms malignant and unspecified
- Placental, amniotic and cavity disorders (excl haemorrhages)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
incidence of intrauterine infection (chorioamnionitis and/or funisitis) in TTTS
after fetoscopic laser surgery
Secondary outcome
1. risk factors of IUI in TTTS after fetoscopic laser surgery
2. disparities of IUI between donor and recipient twin
3. relationship of IUI and neonatal outcomes
Background summary
MC twin pregnancies are regarded as high risk pregnancies primarily due to the
increased risk of TTTS (10%). The best available treatment for TTTS is
fetoscopic laser coagulation of the placental vascular anastomoses.
Nevertheless, TTTS survivors after laser surgery are at increased risk of
cerebral injury and impaired long-term neurodevelopmental outcome. TTTS
pregnancies treated with laser have an increased risk of iatrogenic PPROM (up
to 78-93%), which may be attributed to the creation of a hole in the membranes
after introduction of the fetoscope in the amniotic sac of the recipient twin.
This iatrogenic hole in the membranes may directly expose the recipient twin to
microbial invasion with or without maternal manifestation. PPROM is known to be
associated with increased risk of premature delivery and adverse perinatal
outcome, mainly due to intrauterine infection (IUI). Recent reports have shown
that chorioamnionitis (CA) is associated with neonatal cerebral injury and
adverse long-term neurodevelopmental outcome. Not much is known on the
incidence, risk factors and related perinatal outcome. Only few small studies
have evaluated the occurrence of clinical or histological CA in TTTS treated
with laser. Larger, well-designed studies are urgently required to determine
the incidence and risk factors of CA in TTTS treated by laser.
Study objective
To evaluate the incidence, risk factors and perinatal morbidity and mortality
due to CA after TTTS treated with fetoscopic laser surgery.
Study design
A case control prospective study.
Study burden and risks
no associated risk with participation
Albinusdreef 2
Leiden 2333 ZA
NL
Albinusdreef 2
Leiden 2333 ZA
NL
Listed location countries
Age
Inclusion criteria
All TTTS cases treated with fetoscopic laser surgery at our center are eligible for our study. All monochorionic twins without TTTS delivered at our center will be included in the control group.
Exclusion criteria
Higher order pregnancies will be excluded from the study.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL43297.058.13 |