Improved recipient survival with maternal nifedipine in twin-twin transfusion syndrome complicated by TTTS cardiomyopathy undergoing selective fetoscopic laser photocoagulation - 19/08/11
, Foong-Yen Lim, MD a, b, g, Mounira Habli, MD a, b, d, g, William Polzin, MD a, d, g, Ronald Jaekle, MD a, e, g, Erik Michelfelder, MD a, c, g, James Cnota, MD a, c, g, Chunyan Liu, MS f, g, Mi-Ok Kim, PhD f, g
Reprints: Timothy M. Crombleholme, MD, The Fetal Care Center of Cincinnati, Division of Pediatric General, Thoracic, and Fetal Surgery, Cincinnati Children's Hospital MLC 2023, 3333 Burnet Ave., Cincinnati, OH 45229-3039Résumé |
Objective |
The purpose of this study was to evaluate the effect of maternal nifedipine on fetal survival when started 24-48 hours before selective fetoscopic laser photocoagulation (SFLP).
Study Design |
We conducted a case control study of consecutive cases of twin-twin transfusion syndrome (TTTS) in which TTTS cardiomyopathy was treated with maternal nifedipine 24-48 hours before SFLP, compared with gestational age and stage-matched control cases. The primary outcome was recipient and donor survival.
Results |
One hundred forty-one cases of TTTS were treated with nifedipine, and 152 gestational age- and stage-matched control cases were analyzed. There was a significant increase in overall fetal survival in nifedipine-treated cases compared with control cases (237/284 [83%] vs 232/308 [75%]; P = .015). There is an increase in survival of recipients who were treated with nifedipine in stage IIIA (100% vs 81%; P = .021) and IIIB (93% vs 71%; P = .014); however, there was no difference in donor survival.
Conclusion |
Maternal nifedipine is associated with improved recipient survival in TTTS that undergoes SFLP. This is the first study to suggest a benefit of adjunctive maternal medical therapy in patients with TTTS who undergo SFLP.
Le texte complet de cet article est disponible en PDF.Key words : Cincinnati TTTS staging system, echocardiography, nifedipine, selective fetoscopic laser photocoagulation, TTTS-cardiomyopathy, twin-twin transfusion syndrome
Plan
| Authorship and contribution to the article is limited to the 9 authors indicated. There was no outside funding or technical assistance with the production of this article. |
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| Cite this article as: Crombleholme TM, Lim F-Y, Habli M, et al. Improved recipient survival with maternal nifedipine in twin-twin transfusion syndrome complicated by TTTS cardiomyopathy undergoing selective fetoscopic laser photocoagulation. Am J Obstet Gynecol 2010;203:397.e1-9. |
Vol 203 - N° 4
P. 397.e1-397.e9 - octobre 2010 Retour au numéro
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