Perioperative risk factors of preterm delivery after fetoscopic laser photocoagulation for twin–twin transfusion syndrome

Abstract

Objective: To identify risk factors for preterm delivery (PTD) in patients who received fetoscopic laser photocoagulation (FLP) of placental anastomoses for twin–twin transfusion syndrome (TTTS). Methods: This retrospective cohort study prospectively analyzed and recorded perioperative data in a cohort of patients who had FLP for TTTS, identifying perioperative risk factors for PTD using a Cox proportional hazard regression model. Results: Of 304 patients included, 26 (8.6%) delivered within 4 weeks of FLP. Independent predictors of delivery within 4 weeks of FLP were a history of PTD (hazard ratio [HR]: 5.91, 95% confidence interval [CI]:1.21–28.82, p = 0.03), vaginal bleeding in the second trimester (HR: 6.62, 95% CI: 1.76–24.90, p < 0.01), and amnioreduction ≥1715 mL (HR: 3.16, 95% CI: 1.11–9.05, p < 0.03). Conclusion: Patients with a history of PTD, preoperative vaginal bleeding, and amnioreduction ≥1715 mL were more likely to deliver prematurely.