Abstract
Objective To review literature about treatment of twin–twin transfusion syndrome (TTTS) stage
I.
Materials A search in PubMed, EMBASE, Medline, and reference lists was performed. Inclusion
criteria were TTTS diagnosed with standard criteria and classified with Quintero staging
and survival rates (SR) stratified for stage and first-choice treatment. Outcomes
were SR and progression to advanced stages. Preferred Reporting Items for Systematic
reviews and Meta-Analyses guidelines were followed.
Results Seven articles pooled 262 twin sets treated with amnioreduction (16%), conservative
management (22%), and laser therapy (62%). The overall SR was 77% after amnioreduction,
86% in the conservative management group, and 85% in the laser therapy group. Progression
rate occurred in 30%, 15%, and 0%, respectively. Outcomes were similar between laser
therapy as first- versus second-choice treatment. Because most studies were observational
and not comparative, a meta-analysis was not performed.
Conclusion Conservative management of TTTS stage I is a reasonable option until randomized clinical
trials are presented.
Keywords
twin–twin transfusion syndrome (TTTS) - Quintero staging system - stage I - laser
therapy - conservative management