Timing of intra‐fetal laser therapy for twin reversed arterial perfusion ( TRAP ) sequence: Retrospective series and systematic review and meta‐analysis
- Resource Type
- Authors
- Annachiara Vitucci; Nicola Fratelli; Anna Fichera; Enrico Sartori; Federico Prefumo
- Source
- Subject
- Lasers
Infant, Newborn
Pregnancy Outcome
Infant
Obstetrics and Gynecology
Gestational Age
interstitial laser
Fetofetal Transfusion
General Medicine
TRAP sequence
Perfusion
meta-analysis
fetal therapy
systematic review
Pregnancy
monochorionic twins
Pregnancy, Twin
Humans
Female
Laser Therapy
Retrospective Studies
- Language
- English
To estimate the neonatal survival rate after intra-fetal laser (IFL) treatment for twin reversed arterial perfusion (TRAP) sequence, and to investigate the effect of gestational age at the time of procedure.Retrospective cohort study of TRAP sequences followed at our institution from 2013-2020. Systematic review and meta-analysis of the neonatal survival rate after IFL was conducted. Both diamniotic and monoamniotic monochorionic pregnancies were included. A subgroup analysis to compare outcomes according to gestational age at procedure (16Thirteen pregnancies were followed at our center and seven were treated with IFL: the survival rate was 57%. Ten studies published between 2008 and 2020 for a total of 156 cases were included in the meta-analysis. The overall neonatal survival after IFL was 79% (95% CI 0.72-0.86, IIFL is a safe and minimally invasive technique for the treatment of TRAP sequence, with a survival rate of 79%. Gestational age at treatment (before or after 16 weeks) does not seem to affect neonatal survival rate.