Article
Pediatrics
Angel Chimenea, Lutgardo Garcia-Diaz, Guillermo Antinolo
Summary: This study aimed to evaluate the risk of neurodevelopmental impairment in monochorionic diamniotic twins undergoing fetoscopic laser surgery for twin-twin transfusion syndrome (TTTS) compared to uncomplicated MCDA twin pregnancies. The results showed that the outcome in MCDA twins who underwent surgery for TTTS was comparable to uncomplicated MCDA twins. These findings underscore the importance of long-term neurodevelopmental follow-up in children from monochorionic twin pregnancies.
Article
Obstetrics & Gynecology
Raphael Bartin, Claire Colmant, Nicolas Bourgon, Yves Ville, Julien Stirnemann
Summary: This study evaluated the effect of gestational age at laser therapy for twin-to-twin transfusion syndrome on perinatal outcome. The results showed that gestational age at laser therapy was associated with overall survival and reduction in double fetal loss. The rate of preterm prelabour rupture of membranes was significantly higher in early cases, and gestational age at laser therapy was significantly related to preterm birth and neonatal morbidity.
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
(2022)
Article
Biotechnology & Applied Microbiology
Tianjiao Liu, Li Wen, Shuai Huang, Ting-Li Han, Lan Zhang, Huijia Fu, Junnan Li, Chao Tong, Hongbo Qi, Richard Saffery, Philip N. Baker, Mark D. Kilby
Summary: This study investigated the metabolic changes caused by twin-twin transfusion syndrome and the effects of fetoscopic laser coagulation on placental tissue and cord plasma metabolism. The results showed that cord plasma metabolome performed better in differentiating fetuses with varying hemodynamic statuses. Fetoscopic laser coagulation improved the metabolomic alterations and identified potential biomarkers related to neonatal birth weight and cardiac function.
FRONTIERS IN BIOENGINEERING AND BIOTECHNOLOGY
(2022)
Article
Obstetrics & Gynecology
Nazila Mesbah, Vajiheh Marsousi, Laleh Eslamian, Hadi Montazerlotfelahi, Alireza A. Shamshirsaz, Kamran Hessami, Ashraf Jamal, Maryam Noorzadeh, Mahsa Naemi, Marjan Ghaemi
Summary: This study evaluated the neurodevelopmental outcomes at 12 months of age among infants with TTTS undergoing FLP. The results showed that 10.2% of the infants had minor or major neurodevelopmental impairment. This information is useful for counseling couples before undergoing the procedure.
BMC PREGNANCY AND CHILDBIRTH
(2022)
Review
Acoustics
K. Hessami, A. A. Nassr, N. Sananes, J. Castillo, H. A. Castillo, M. Sanz Cortes, J. Espinoza, R. V. Donepudi, R. C. Sun, E. Krispin, M. A. Belfort, A. A. Shamshirsaz
Summary: The incidence of NDI in TTTS survivors is 14.0%, and is associated with later gestational age at the time of FLP, earlier gestational age at delivery, and lower birth weight. Preterm birth before 32 weeks is linked to a higher risk of NDI.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2021)
Article
Medicine, General & Internal
Xueju Wang, Luyao Li, Pengbo Yuan, Yangyu Zhao, Yuan Wei
Summary: This study investigated the impact of fetoscopic laser surgery on TTTS patients and found that the laser group had significantly improved gestational age, TTTS stage, and delivery gestational age compared to the control group. Furthermore, in the laser group, there was a positive correlation between birth-weight discordance and placental territory discordance.
FRONTIERS IN MEDICINE
(2022)
Review
Obstetrics & Gynecology
Liesbeth Lewi
Summary: About 1 in 5 twin pregnancies are monochorionic diamniotic, which can lead to transfusion imbalances and other complications. Fetoscopic laser coagulation is used to address these imbalances. In addition, structural anomalies are more common in monochorionic twins while chromosomal anomalies are less common.
AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM
(2022)
Article
Medicine, General & Internal
Izabela Walasik, Magdalena Litwinska, Katarzyna Janiak, Krzysztof Szaflik, Piotr Kaczmarek, Artur Ludwin, Ewelina Litwinska
Summary: This study compared the short- and long-term outcomes of monochorionic twin pregnancies with the Twin Reversed Arterial Perfusion Sequence (TRAP) using two different techniques: interstitial fetal laser (IFL) and endoscopic cord occlusion (CO). The study found that IFL was associated with a higher risk of early pregnancy loss, but lower risks of preterm birth and neurological disabilities in survivors, while CO showed the opposite results.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Genetics & Heredity
Anna M. Armitage, Monica A. Kundra, Neda Ghiam, Paldeep S. Atwal, Dayna Morel, Kathleen S. Hruska, Rebecca Torene, Irman Forghani
Summary: This case report describes the first instance of blood chimerism involving a pathogenic RB1 variant in naturally conceived monochorionic-dizygotic twins with twin-twin-transfusion syndrome, likely due to stem cell exchange. The affected twin developed bilateral retinoblastoma at 7 months of age, with both twins having a 20% allelic ratio of the RB1 pathogenic variant in their blood. Subsequent genotyping confirmed dizygosity, with the affected twin harboring the variant in skin and blood, while the unaffected twin only had the variant in blood.
AMERICAN JOURNAL OF MEDICAL GENETICS PART A
(2021)
Article
Genetics & Heredity
Elina A. Lopriore, Femke Slaghekke, E. Joanne Verweij, Monique C. Haak, Annemieke J. M. Middeldorp, Enrico Lopriore
Summary: This study aimed to describe the neonatal management and outcome in monochorionic twins with twin-to-twin transfusion syndrome (TTTS) not treated with fetoscopic laser surgery. The results showed that the risk for adverse neonatal outcome was three-fold higher in TTTS not treated with laser compared to TTTS treated with laser, emphasizing the need for accurate and prompt intensive treatment for these sick neonates at birth.
TWIN RESEARCH AND HUMAN GENETICS
(2022)
Article
Automation & Control Systems
Jonas Lussi, Simone Gervasoni, Michelle Mattille, Roland Dreyfus, Quentin Boehler, Michael Reinehr, Nicole Ochsenbein, Bradley J. Nelson, Ueli Moehrlen
Summary: A robotic platform using remote magnetic navigation for fetoscopic surgery is proposed in this study, which can effectively treat twin-to-twin transfusion syndrome with flexibility, dexterity, safety, and precision.
ADVANCED INTELLIGENT SYSTEMS
(2022)
Review
Obstetrics & Gynecology
Filomena Giulia Sileo, Francesco D'antonio, Can Benlioglu, Amar Bhide, Asma Khalil
Summary: This systematic review and meta-analysis evaluated the outcomes of monochorionic-diamniotic twin pregnancies affected by late TTTS with different management options. The results indicated a need for further high-quality research to determine the optimal management of these pregnancies, as evidence on perinatal mortality and morbidity was of very low quality.
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA
(2021)
Article
Obstetrics & Gynecology
Yao-Lung Chang, Sheng-Yuan Su, An-Shine Chao, Shuenn-Dyh Chang, Wen- Lee, Ming-Chou Chiang
Summary: This case report presents a rare monochorionic dizygotic twin pregnancy complicated with twin-twin transfusion syndrome (TTTS) and successfully treated with laser therapy. The twins, born prematurely at 29 weeks due to severe preeclampsia, were found to be an XX and XY chimera with no neurological sequelae at discharge, highlighting the effectiveness of laser therapy in such cases and the importance of early determination of chorionicity in monochorionic twin pregnancies.
TAIWANESE JOURNAL OF OBSTETRICS & GYNECOLOGY
(2021)
Article
Medicine, General & Internal
Anthea de Sainte Fare, Ivonne Bedei, Aline Wolter, Johanna Schenk, Ellydda Widriani, Corinna Keil, Siegmund Koehler, Franz Bahlmann, Brigitte Strizek, Ulrich Gembruch, Christoph Berg, Roland Axt-Fliedner
Summary: This study analyzes the effectiveness of different MCA-PSV cut-off levels in prenatal diagnosis of TAPS in MCDA twins. The results show that using a delta MCA-PSV > 0.5 MoM method detects more TAPS cases, while the threshold method based on current guidelines may lead to prenatal misdiagnosis.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Genetics & Heredity
Hadar Rosen, Ronit Silber, Anat Schwartz, Hagai Avnet, Shlomo Lipitz, Shai Shrot, Chen Hoffmann, Boaz Weisz, Yoav Yinon
Summary: The study found that TAPS increases the risk of fetal and neonatal brain injuries. Fetal brain imaging can improve the accuracy of prenatal diagnosis, enabling accurate parental counseling and post-natal care.
PRENATAL DIAGNOSIS
(2022)
Article
Genetics & Heredity
Elina A. Lopriore, Femke Slaghekke, E. Joanne Verweij, Monique C. Haak, Annemieke J. M. Middeldorp, Enrico Lopriore
Summary: This study aimed to describe the neonatal management and outcome in monochorionic twins with twin-to-twin transfusion syndrome (TTTS) not treated with fetoscopic laser surgery. The results showed that the risk for adverse neonatal outcome was three-fold higher in TTTS not treated with laser compared to TTTS treated with laser, emphasizing the need for accurate and prompt intensive treatment for these sick neonates at birth.
TWIN RESEARCH AND HUMAN GENETICS
(2022)
Letter
Pediatrics
M. J. A. van de Sande, E. Lopriore, E. J. T. Verweij, C. de Bruin, F. Slaghekke, L. S. A. Tollenaar
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION
(2023)
Article
Obstetrics & Gynecology
Sophie G. Groene, Enrico Lopriore
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2023)
Article
Hematology
Linda M. Henricks, Elise J. Huisman, Enrico Lopriore, Jessie S. Luken, Masja de Haas, Claudia S. Ootjers, Arjan Albersen
Summary: In this case, a preterm neonate experienced an acute hemolytic reaction due to the administration of plasma product containing auto-antibodies. This adds a new argument to the discussion on expanding the use of solvent/detergent-treated plasma to the pediatric population.
TRANSFUSION MEDICINE
(2023)
Article
Pediatrics
Alexandra Scrivens, Nora Johanna Reibel, Lisanne Heeger, Simon Stanworth, Enrico Lopriore, Helen New, Christof Dame, Karin Fijnvandraat, Emoke Deschmann, Marta Aguar, Kristin Braekke, Francesco Stefano Cardona, Filip Cools, Ryan Farrugia, Stefano Ghirardello, Jana Lozar, Katarina Matasova, Tobias Muehlbacher, Ulla Sankilampi, Henrique Soares, Miklos Szabo, Tomasz Szczapa, Gabriela Zaharie, Charles Christoph Roehr, Suzanne Fustolo-Gunnink
Summary: This survey found significant variation in transfusion practices among NICUs in Europe, with liberal thresholds for transfusion compared to recent trial data. There is a need for further research to understand the barriers and enablers to incorporating recent trial findings into neonatal transfusion practice.
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION
(2023)
Article
Pediatrics
Hylke H. Salverda, Janneke Dekker, Enrico Lopriore, Peter A. Dargaville, Steffen C. Pauws, Arjan B. te Pas
Summary: The effect of two different automated oxygen control devices on the time preterm infants spent in different ranges of oxygen saturation was compared in this study. The results showed that infants under OxyGenie control spent more time within the target range of oxygen saturation and less time in hypoxic and hyperoxic ranges.
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION
(2023)
Article
Hematology
Sophie J. Jansen, Isabelle M. C. Ree, Lana Broer, Derek de Winter, Masja de Haas, Vincent Bekker, Enrico Lopriore
Summary: This study aimed to investigate the frequency of central-line use, indications for insertion, and the incidence of sepsis among neonates with hemolytic disease of the fetus and newborn (HDFN). The results showed that central-line placement was associated with an increased risk of sepsis and late-onset infection. This suggests that central-line placement should be delayed until the likelihood of exchange transfusion is high.
Article
Pediatrics
Carmel Maria Moore, Angela D'Amore, Suzanne Fustolo-Gunnink, Cara Hudson, Alice Newton, Beatriz Lopez Santamaria, Alison Deary, Renate Hodge, Valerie Hopkins, Ana Mora, Charlotte Llewelyn, Vidheya Venkatesh, Rizwan Khan, Karen Willoughby, Wes Onland, Karin Fijnvandraat, Helen New, Paul Clarke, Enrico Lopriore, Timothy Watts, Simon Stanworth, Anna Curley
Summary: This study aims to assess mortality and neurodevelopmental outcomes in children participating in the PlaNeT-2/MATISSE study at 2 years of corrected age. The results show that a higher platelet transfusion threshold is associated with significantly increased mortality or major bleeding compared to a lower one. This further supports evidence of harm caused by high prophylactic platelet transfusion thresholds in preterm infants.
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION
(2023)
Editorial Material
Obstetrics & Gynecology
Enrico Lopriore
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
(2023)
Article
Obstetrics & Gynecology
Salma El Emrani, Sophie G. Groene, Jip A. Spekman, Femke Slaghekke, Lotte E. van der Meeren, Nicoline E. Schalij-Delfos, Enrico Lopriore
Summary: The study aimed to evaluate the difference in retinopathy of prematurity (ROP) between donors and recipients with twin-to-twin transfusion syndrome (TTTS) and identify risk factors for ROP development. The rates of any stage ROP and severe ROP were significantly higher in donors compared to recipients. Donor status, lower gestational age at birth, and longer mechanical ventilation days were independently associated with the occurrence of any stage ROP. Donor status was also associated with the occurrence of severe ROP. Increased awareness for ROP is needed in donors, especially those with lower gestational age at birth and longer duration of mechanical ventilation.
FETAL DIAGNOSIS AND THERAPY
(2023)
Article
Pediatrics
Jip A. Spekman, Salma El Emrani, Nicoline E. Schalij-Delfos, Femke Slaghekke, Jeanine M. M. van Klink, Enrico Lopriore, Sophie G. Groene
Summary: Research investigates the effect of fetal growth restriction (FGR) on retinopathy of prematurity (ROP) in growth-discordant identical twins, controlling for confounding factors. Results show that FGR is associated with almost tripled odds of ROP development, suggesting that unfavorable antenatal growth conditions and adverse neonatal outcomes affect postnatal retinal vascular proliferation.
PEDIATRIC RESEARCH
(2023)
Editorial Material
Pediatrics
Enrico Lopriore
Review
Obstetrics & Gynecology
Derek P. de Winter, Allysen Kaminski, May Lee Tjoa, Dick Oepkes, Enrico Lopriore
Summary: There is limited knowledge regarding the frequency of postnatal treatment and clinical outcomes of neonates with hemolytic disease of the fetus and newborn (HDFN). This study aimed to evaluate the postnatal treatment landscape and clinical outcomes in neonates with Rhesus factor D (Rh(D))- and/or K-mediated HDFN. The findings highlight a shortage and inconsistency in the reporting of relevant data and provide recommendations for future research.
BMC PREGNANCY AND CHILDBIRTH
(2023)
Article
Obstetrics & Gynecology
Patricia J. C. Knijnenburg, Femke Slaghekke, Chinar Rahmattulla, Yuchun Ge, Irene M. Scholl, Jeanine M. M. van Klink, Monique C. Haak, Johanna M. Middeldorp, Luming Sun, Enrico Lopriore
Summary: This study retrospectively assessed the prevalence, risk factors, and outcomes of intertwin membrane perforation and subsequent cord entanglement after laser surgery for twin-twin transfusion syndrome (TTTS). The results showed that 16% of TTTS pregnancies treated with laser surgery experienced intertwin membrane perforation, and this led to cord entanglement in 21% of cases. Intertwin membrane perforation was associated with higher laser power settings, a second fetal surgery procedure, higher rate of cesarean section, lower gestational age at birth, and a higher risk of severe cerebral injury.
FETAL DIAGNOSIS AND THERAPY
(2023)
Review
Medicine, General & Internal
Mathies Rondagh, Enrico Lopriore, Linda S. de Vries, Femke Slaghekke, Lisanne S. A. Tollenaar, Jeanine M. M. van Klink, Sophie G. Groene, Sylke J. Steggerda
Summary: The distinct placental angioarchitecture in monochorionic pregnancies increases the risk of complications, such as twin-twin transfusion syndrome, twin anemia polycythemia sequence, and selective fetal growth restriction. This systematic review evaluates the incidence and severity of cerebral injury and structural brain development in MC twins with or without complications. More research and standardized protocols are needed to enhance our understanding of these risks and pathophysiological mechanisms.
JOURNAL OF CLINICAL MEDICINE
(2023)
