Type II and III Selective Fetal Growth Restriction: Perinatal Outcomes of Expectant Management and Laser Ablation of Placental Vessels

• Autor(a) principal: Miyadahira, Mariana Yumi
• Data de Publicação: 2018
• Outros Autores: Brizot, Maria de Lourdes, Carvalho, Mário Henrique Burlacchini de, Biancolin, Sckarlet Ernandes, Machado, Rita de Cássia Alam, Krebs, Vera Lúcia Jornada, Francisco, Rossana Pulcineli Vieira, Peralta, Cleisson Fábio Andrioli
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Clinics
• Texto Completo: https://www.revistas.usp.br/clinics/article/view/146261
• topic: Twin Pregnancy; Monochorionic Pregnancy; Selective Fetal Growth Restriction; Expectant Management; Laser Ablation of Placental Vessels; Perinatal Outcomes

OBJECTIVES: To describe the perinatal outcomes of type II and III selective fetal growth restriction (sFGR) in monochorionic-diamniotic (MCDA) twin pregnancies treated with expectant management or laser ablation of placental vessels (LAPV). METHODS: Retrospective analysis of cases of sFGR that received expectant management (type II, n=6; type III, n=22) or LAPV (type II, n=30; type III, n=9). The main outcomes were gestational age at delivery and survival rate. RESULTS: The smaller fetus presented an absent/reversed “a” wave in the ductus venosus (arAWDV) in all LAPV cases, while none of the expectant management cases presented arAWDV. The median gestational age at delivery was within the 32nd week for expectant management (type II and III) and for type II LAPV, and the 30th week for type III LAPV. The rate of at least one twin alive at hospital discharge was 83.3% and 90.9% for expectant management type II and III, respectively, and 90% and 77.8% for LAPV type II and III, respectively. CONCLUSION: LAPV in type II and III sFGR twins with arAWDV in the smaller fetus seems to yield outcomes similar to those of less severe cases that received expectant management.