Multi-center collaborative review of pregnant women undergoing fetoscopic laser surgery (FLS)

Multi-center collaborative review of pregnant women undergoing fetoscopic laser surgery (FLS) for Twin-Twin Transfusion syndrome (TTTS) with a short cervical length.

Despite the success of fetoscopic laser surgery (FLS) for severe twin-twin transfusion syndrome, preterm delivery continues to be a challenge and determines perinatal survival and morbidity. The average gestational age at delivery after FLS for TTTS ranges from 29 weeks to 33 weeks, compared to 36-37 weeks in healthy monochorionic twin pregnancies. The factors that have been associated with preterm delivery after FLS for TTTS includes a short cervical length, post-operative fetal membrane separation at the site of entry and preterm premature rupture of membranes. The primary objective is to evaluate the use of a cervical pessary, vaginal progesterone, cervical pessary in combination with progesterone and no treatment in women who underwent FLS for TTTS with a short cervical length of less than 30 mm. For more questions about this study, please contact the Principal Investigator, Ramesha Papanna, MD, MPH, at ramesha.papanna@uth.tmc.edu or at 832-500-6423.