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Peer-reviewedCC BY-NC-ND 4.0The Journal of Obstetrics and Gynaecology Research

Fetoscopic Treatment of Twin‐to‐Twin Transfusion Syndrome After Spontaneous Preoperative Preterm Premature Rupture of the Membranes

  • Rodrigo Ruano1
  • Kavita Narang2
  • Gabriele Tonni3
  1. 1Division of Maternal‐Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences University of Miami Miller School of Medicine and Jackson Memorial Hospital Miami Florida USA
  2. 2Division of Maternal‐Fetal Medicine Valleywise Comprehensive Health Center/Valleywise Health Medical Center Phoenix Arizona USA
  3. 3Department of Obstetrics & Gynecology, Azienda Sanitaria Locale di Reggio Emilia Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Reggio Emilia Reggio Emilia Italy
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Abstract

We successfully performed a fetoscopic laser ablation (FLA) followed by amniopatch immediately after spontaneous preterm premature rupture of the membranes (PPROM) occurred in a 23‐week monochorionic‐diamniotic twin pregnancy complicated by Stage II twin‐to‐twin transfusion syndrome (TTTS). Since the severe polyhydramnios‐anhydramnios sequence was still observed after spontaneous PPROM, we established an emergent multidisciplinary meeting and consulted the hospital Fetal Ethical Boards. After multidisciplinary consensus and ethical approval, the procedure was successfully performed on the same day without complications. On Postoperative Day 1, no more leakage of fluid was observed. The patient had an uncomplicated course during the entire pregnancy, with complete resolution of the TTTS and the PPROM. At 34 weeks' gestation, she delivered two healthy twins by cesarean section. The infants are now 4 years old with complete normal neurological development. In conclusion, we demonstrate that FLA with amniopatch is a feasible option in specific cases of TTTS with preoperative PPROM.

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Cite

BibTeXRIS
BibTeX
@article{ruano2026fetoscopic,
  title = {{Fetoscopic Treatment of Twin‐to‐Twin Transfusion Syndrome After Spontaneous Preoperative Preterm Premature Rupture of the Membranes}},
  author = {Rodrigo Ruano and Kavita Narang and Gabriele Tonni},
  journal = {The Journal of Obstetrics and Gynaecology Research},
  year = {2026},
  month = nov,
  doi = {10.1111/jog.70542},
  url = {https://doi.org/10.1111/jog.70542},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Fetoscopic Treatment of Twin‐to‐Twin Transfusion Syndrome After Spontaneous Preoperative Preterm Premature Rupture of the Membranes
AU  - Rodrigo Ruano
AU  - Kavita Narang
AU  - Gabriele Tonni
PY  - 2026
DA  - 2026/11/04
JO  - The Journal of Obstetrics and Gynaecology Research
DO  - 10.1111/jog.70542
UR  - https://doi.org/10.1111/jog.70542
AB  - We successfully performed a fetoscopic laser ablation (FLA) followed by amniopatch immediately after spontaneous preterm premature rupture of the membranes (PPROM) occurred in a 23‐week monochorionic‐diamniotic twin pregnancy complicated by Stage II twin‐to‐twin transfusion syndrome (TTTS). Since the severe polyhydramnios‐anhydramnios sequence was still observed after spontaneous PPROM, we established an emergent multidisciplinary meeting and consulted the hospital Fetal Ethical Boards. After multidisciplinary consensus and ethical approval, the procedure was successfully performed on the same day without complications. On Postoperative Day 1, no more leakage of fluid was observed. The patient had an uncomplicated course during the entire pregnancy, with complete resolution of the TTTS and the PPROM. At 34 weeks' gestation, she delivered two healthy twins by cesarean section. The infants are now 4 years old with complete normal neurological development. In conclusion, we demonstrate that FLA with amniopatch is a feasible option in specific cases of TTTS with preoperative PPROM.
SN  - 1341-8076
SN  - 1447-0756
ER  -