Poster Session 2
.jpg "Neha Agarwal, MBBS, MD photo")
Neha Agarwal, MBBS, MD
Post doctoral Research Fellow
Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, UTHealth McGovern Medical School, Houston, TX, USA
Houston, Texas, United States
Ramesha Papanna, MD, MPH
Professor
McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Dejian Lai, PhD
Professor
UT School of Public Health
Houston, Texas, United States
.jpg "Anthony Johnson, DO photo")
Anthony Johnson, DO
Professor
McGovern Medical School University of Texas Health Science Center at Houston (UThealth)
Houston, Texas, United States
Sami Backley, MD
Clinical Fellow PGY 9
Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Eric P. Bergh, MD
Associate Professor
Nemours Children's Health
Wilmington, Delaware, United States
Edgar A. Hernandez-Andrade, MD, PhD (he/him/his)
Professor
McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Gustavo Vilchez, MD, MSCR
UTHealth Houston
Houston, Texas, United States
Felicia V. LeMoine, MD (she/her/hers)
Fetal Intervention Fellow
Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Alexandra Garcia, BS
Resident
Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Tania clarete, RN
Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Elisa Garcia, MPH, RN
Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Ashley Salazar, DNP
Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UT Health Houston
Houston, Texas, United States
Jimmy Espinoza, MD, MSc
Professor
Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
To evaluate the risk factors associated with maternal abruption in twin-twin transfusion syndrome (TTTS) after fetoscopic laser surgery (FLS).
Study Design: This retrospective study included TTTS cases that underwent FLS between 2011 and 2024 at a single institution. Maternal demographics and preoperative, intraoperative and postoperative outcomes were collected. Patients were subsequently grouped by abruption status. Placental abruption was diagnosed based on documentation in the medical record. Multiple logistic regression analysis was performed to identify risk factors, adjusted for maternal ethnicity, placental location, gestational age at FLS, amnioinfusion, amnioreduction, number of uterine entries, Solomonization, laser time and kilojoules, chorioamnion separation (CAS) observed on the first postoperative day, and preterm prelabor rupture of membrane (PPROM).
Results: 749 patients were enrolled in the study. Among them, 88 (11.7%) were complicated by maternal abruption. Patients with abruption delivered earlier than those without abruption (29.2 [26.3, 31.5] wks. vs 32 [28.5, 34.2] wks., p < 0.001). There were no significant statistical differences in maternal age, race, BMI, smoking status or other demographics or intraoperative variables between groups (Table 1). Rates of CAS (18.1% [16/88] vs. 9.6% [64/661], p=0.04) and PPROM (61.3% [54/93] vs 37% [245/655], p=0.001) were statistically significantly higher among the abruption group than the no abruption group. Multiple logistical regression demonstrated that CAS and PPROM are significant risk factors for placental abruption ([aOR, 2.04; 95% CI 1.01 – 4.11, p=0.04] and [aOR, 2.16; 95% CI 1.29-3.61, p=0.003], respectively).
Conclusion:
CAS and PPROM are significant risk factors for placental abruption. After FLS, patients with CAS and PPROM should be advised of the increased risk for placental abruption.
