Does the order of ablation of vein-to-vein placental connections during fetoscopic laser photocoagulation affect outcomes in twin-twin transfusion syndrome?
Am J Obstet GynecolMay 23, 2026 (epub)
Clinical ResearchObstetrics & Gynecology
Ramen H Chmait, Lisa M Korst, Arlyn S Llanes et al.
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In 30 seconds
This post hoc analysis of a randomized controlled trial evaluated the impact of the sequence of laser ablation of vein-to-vein placental connections on fetal survival in twin-twin transfusion syndrome. Among 64 patients with vein-to-vein anastomoses, donor survival was significantly lower in the Ablated Last group (69.4%) compared to the No Superficial Anastomoses group (90.3%), with a P-value of <.001.
Key findings
- Donor survival was 82.1% in the Ablated First group and 69.4% in the Ablated Last group (P<.001).
- Adjusted odds ratio for donor survival in the Ablated Last group was 0.24 (0.10-0.58; P=.002).
- Recipient survival was 86.1% in the Ablated Last group compared to 94.2% in the No Superficial Anastomoses group (P=.128).
- Adjusted odds ratio for recipient survival in the Ablated Last group was 0.30 (0.10-0.92; P=.035).
Why it matters
Understanding the optimal sequence for laser ablation in twin-twin transfusion syndrome can inform clinical practice and potentially improve survival outcomes for both donor and recipient twins.