Outcome of laser photocoagulation for monochorionic twins complicated by selective fetal growth restriction Type II.

A total of 98 patients with MCDA twins met our inclusion criteria, with 56 sub-classified as Type IIA and 42 as Type IIB. Demographic characteristics were similar between the groups; however, Type IIB cases tended to have an earlier gestational age at diagnosis and at laser surgery as well as larger intertwin estimated fetal weight discordance, which may be a reflection of disease severity. Postnatal survival of the growth-restricted fetus was significantly lower in Type IIB compared to Type IIA cases (23.8% vs 46.4%, P = 0.034) CONCLUSIONS: In MCDA twins complicated by sFGR Type II and treated with laser photocoagulation of placental anastomoses, preoperative Doppler assessment of the ductus venosus and middle cerebral artery help to identify subset of patients at increased risk of demise of the growth-restricted fetuses following intervention. Our study provides valuable information for guiding the surgical management options and patient counseling. This article is protected by copyright. All rights reserved.