EP14.21: Impact of selective fetal growth restriction on survival after fetoscopic laser ablation in Twin–twin transfusion syndrome (TTTS)

To compare survival rates at birth in monochorionic diamniotic twin (MCDA) pregnancies complicated by Twin–twin transfusion syndrome (TTTS) with and without selective fetal growth restriction (sFGR) treated by fetoscopic laser photocoagulation (FLP). Retrospective cohort study of all cases of MCDA twins complicated by TTTS and treated by FLP at Hospital Italiano de Buenos Aires between January 2012 and February 2024. We compared survival rates between pregnancies with and without concomitant sFGR, adjusted by TTTS stage (I-II vs. III-IV). sFGR was defined according to ISUOG definition as one fetus with EFW < 10th centile and the intertwin EFW discordance > 25%. We included 209 pregnancies: 120 (57.4%) with TTTS and 89 (42.6%) with TTTS + sFGR. There was no difference in the gestational age (GA) of FLP and in the GA at delivery among both groups. Survival at birth was higher in the TTTS-only group, mainly due to better outcomes in the stages III-IV compared to the TTTS+sFGR group (see figure 1). sFGR has a significant impact on survival after fetoscopic laser ablation in TTTS in stage III-IV. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.