Patients with stage 1 twin-twin transfusion syndrome (TTTS) may now enroll in an international research study comparing conservative management and selective laser photocoagulation (SLPC) surgery in stage 1 TTTS. SLPC is performed before birth to stop the uneven blood flow between the two fetuses.
TTTS affects 10 percent to 15 percent of monochorionic twin pregnancies (shared placenta). This condition results from an imbalance in the direction of blood flow within the shared placenta, resulting in one twin receiving too much blood volume and the other twin not receiving enough. Without intervention, TTTS results in the death of one or both fetuses in 80 percent to 100 percent of cases.
Over the last several decades, great progress has been made in the ability to treat TTTS. While the overall benefit of fetoscopic laser surgery as a first-line treatment has been established for patients with more severe stages of the condition, patients with stage 1 TTTS, the least severe stage, have traditionally been followed by close observation. This “conservative management” has never been formally compared to first-line fetoscopic laser surgery in patients with stage 1 TTTS.
The objective of this research study is to compare both strategies for patients with stage 1 TTTS to determine an evidence-based standard of care.
Study participants will be assigned to one of two groups:
- The conservative management group will be followed on a weekly basis as long as mother and babies remain stable and until an adequate gestational age is reached to allow delivery. If the condition of the mother or twins worsens, the appropriate intervention will be performed.
- The immediate laser group will be treated with SLPC within 72 hours following assignment.
Comprehensive evaluation of each pregnancy is essential to determine if a patient qualifies for this clinical trial. To refer a patient or discuss a case, call us at 1-800-IN UTERO (800-468-8376).
Additional study details and criteria can be found on clinicaltrials.gov.