Abstract: Twin-to-twin transfusion syndrome (TTTS) is a challenging complication in monochorionic\ndiamniotic (MCDA) twins. Intrauterine interventions, such as fetoscopic laser ablation and cord\nocclusion followed by amniodrainage, are established treatments. Little is known about maternal\ncomplications and hemodynamics following these interventions. We performed a retrospective\nanalysis of maternal procedure-related complications and the impact of such procedures on maternal\nhemodynamics and blood characteristics. Within the study period, 100 women with severe\nTTTS treated by fetoscopic laser ablation (FLA) or cord occlusion (CO) were identified. Clinically\nrelevant maternal complications were reported in four (4%) cases. There was a significant decrease\nin hemoglobin, hematocrit, and albumin between admission and postoperative measurements\n(all p < 0.001). Systolic and diastolic blood pressure, as well as maternal heart rate, decreased from\ntime of skin suture to postoperative measurements (all p < 0.001). Within a 24 h interval, there\nwas a positive correlation between hematocrit (Spearmanâ??s rho 0.325; p=0.003), hemoglobin\n(Spearmanâ??s rho 0.379; p < 0.001), and albumin (Spearmanâ??s rho 0.360; p=0.027), and the amount\nof amniodrainage during the intervention. Maternal procedure-related complications are relatively\nrare. Significant hemodynamic alterations and maternal hemodilution are common clinical findings\nfollowing intrauterine interventions.
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