Intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome
Summary
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome.
Description
Twin-to-twin transfusion syndrome occurs when unborn identical twins have different sacs in the womb but share the same placenta. This results in blood flow from one twin to the other through connections between blood vessels in the shared placenta becoming unbalanced. The volume of fluid around the twins also becomes uneven. This procedure is performed under regional analagesia or local anaesthesia with maternal sedation. Under ultrasound guidance, a cannula and needle are inserted through the maternal abdominal wall, uterine wall and into the amniotic sac of the recipient twin. The needle is removed, and a fetoscope with a thin fibre to carry the laser energy is then inserted through the cannula. The fetoscope is used to look at the blood vessels on the surface of the placenta. Vessels that are found to communicate between the twins are then coagulated using the laser. After completion of surgery, excess amniotic fluid in the recipient twin's sac is removed to achieve a normal volume.
OPCS code:
Details
British Association of Perinatal Medicine
British Maternal and Fetal Medicine Society
Royal College of Paediatrics and Child Health
Royal College of Obstetricians & Gynaecologists
Contact details:
(for general enquiries or comments)
(for procedure specific enquiries or comments)
ip@nice.org.uk
Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA
