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.

OPCS4.6 Code(s):

R07.1 Endoscopic laser ablation of placental arteriovenous anastomosis

Y53.2 Approach to organ under ultrasonic control

A code from category Y95.- Gestational age must be assigned in a subsidiary position where this information is available.

_{The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.  www.connectingforhealth.co.uk/clinicalcoding}

 

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Links:

	IPG198 Intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome: guidance (web format)	11 February 2011
	IPG198 Intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome - guidance	13 December 2006
	IPG198 Intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome - information for the public	13 December 2006
	IPG198 Intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome - information for the public (MS Word format)	13 December 2006
	IPG198 Trin syndrom trallwysiad efaill-i-efaill gydag abladiad laser mewngroth: deall canllawiau NICE (fformat MS Word)	15 October 2009
	Intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome (interventional procedures consultation)	29 August 2006
	Intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome (interventional procedures overview)	29 August 2006