Table 4.
Outcome of 150 monochorionic twin pregnancies diagnosed prenatally with post‐laser twin anemia–polycythemia sequence (TAPS), according to initial management strategy after diagnosis
| Variable | Expectant management (n = 62 pregnancies; n = 124 fetuses) | Laser surgery (n = 24 pregnancies; n = 48 fetuses) | IUT (± PET) (n = 44 pregnancies; n = 88 fetuses) | Delivery (n = 9 pregnancies; n = 18 fetuses) | Selective feticide (n = 11 pregnancies; n = 22 cotwins) | P |
|---|---|---|---|---|---|---|
| GA at birth (weeks) | 32.6 (29.4–34.6) | 31.7 (29.1–33.7) c | 29.9 (29.0–33.0)†, ‡ | 29.0 (27.7–31.8) | 32.6 (31.13–34.0) | 0.027 |
| Diagnosis‐to‐birth interval (weeks) | 8.0 (4.7–14.3) | 8.1 (5.9–11.4) | 4.8 (2.5–8.9)‡ | 0.3 (0.2–0.4)†, ‡ | 10.4 (9.2–14.4) | < 0.001 |
| Perinatal mortality* | 27/124 (22) | 12/47 (26) c | 23/88 (26) | 4/18 (22) | 0/11 (0)† | 0.217 |
| Fetal demise* | 19/124 (15) | 8/47 (17) c | 16/88 (18) | 0/18 (0)† | 0/11 (0)† | 0.268 |
| Neonatal mortality* | 8/105 (8) | 4/39 (10) c | 7/72 (10) | 4/18 (22)†, ‡ | 0/11 (0) | 0.040 |
| Survivors | ||||||
| None* | 4/62 (6) | 3/23 (13) c | 3/44 (7) | 1/9 (11) | 0/11 (0) | 0.692 |
| One | 19/62 (31) | 4/23 (17) c | 16/44 (36) | 2/9 (22) | 11/11 (100) | < 0.001 |
| Two* | 39/62 (63) | 16/23 (70) c | 25/44 (57) | 6/9 (67) | 0/11 (0) | 0.002 |
| At least one | 58/62 (94) | 20/23 (87) c | 41/44 (93) | 8/9 (89) | 11/11 (100) | 0.692 |
| Severe neonatal morbidity | 34/100 (34) a | 12/37 (32) d | 34/72 (47) | 9/17 (53) g , † | 3/11 (27) | 0.158 |
| Severe cerebral injury* | 8/100 (8) a | 3/37 (8) d | 9/72 (13) | 3/17 (18) g , † | 0/11 (0) | 0.141 |
| Postnatal TAPS | 35/43 (81) | 2/14 (14) | 19/27 (70) | 8/9 (89) | — | < 0.001 |
| BT or PET at birth for TAPS* | 45/99 (45) b | 4/36 (11) e , †, ‡ | 33/68 (49) f | 8/17 (47) g | 0/10 (0) h | 0.011 |
Data are presented as median (interquartile range) or n/N (%).
Data missing for:
five infants (two that died shortly after birth and three with unknown outcome);
six infants (same as ‘a’ plus one with missing BT/PET data);
one infant with unknown outcome;
three infants (one with unknown outcome and two with unknown neonatal morbidity);
four infants (same as ‘d’ plus one with missing BT/PET data);
four neonates with unknown BT/PET data;
one infant that died shortly after birth;
one cotwin with missing BT/PET data.
For comparisons using one‐way analysis of variance and generalized estimated equation (all outcomes per fetus/neonate and continuous outcomes per pregnancy), expectant management was set as reference.
For comparisons using chi‐square test (categorical outcomes per pregnancy), P‐values are for comparison between all treatment groups.
Statistical correction for non‐occurring events was applied.
Smallest P‐value, which is presented in P‐value column.
Statistically significant P‐value.
BT, blood transfusion; GA, gestational age; IUT, intrauterine transfusion; PET, partial exchange transfusion.