Experience in Laser Coagulation of Placentary Anastomoses in Selective Foetal Growth Retardation

Abstract

Objective of the Paper: To describe the course and outcome of a pregnancy with monochorionic-diamniotic twins with marked selective foetal growth retardation (sFGR) after laser coagulation of placentary anastomoses. Key points. Fetoscopy-guided laser coagulation of placentary anastomoses at week 21–22 of gestation made it possible to prolong the pregnancy to the term and eliminate the risks of intrauterine foetal death, preterm delivery, and neurological complications in a larger foetus. Conclusion. In sFGR with umbilical artery blood flow type II or III (E. Grtacós), it is possible to use placentary anastomosis or umbilical vessels coagulation in a smaller foetus. Further studies are needed with unified diagnostic criteria and outcome analysis; and pregnancy management approach needs to be developed. Keywords: twin-to-twin transfusion syndrome, laser coagulation of placentary anastomoses, selective foetal growth retardation.