TTTS. Methods
Standard sonographic diagnostic criteria for TTTS included polyhydramnios in the recipient twin (maximum vertical pocket [MVP] ?8 cm), oligohydramnios in the donor twin (MVP ?2 cm), single placenta, same gender, and thin-dividing membrane with absent ? or twin-peak sign.
Each case was prospectively classified using the Quintero staging system,15 as described in Chapter 7. Primary UCO was offered if there was (1) presence of a lethal discordant fetal anomaly, or (2) stage III/IV in a patient who elected this modality.
All patients were informed of the potential risks and benefits of the proposed therapies, as well as the investigational nature of each. Patients choosing primary UCO were asked to reconsider other options such as selective laser photocoagulation of communicating vessels (SLPCV), but their final management decision was respected.
The study was approved by the Institutional Review Board. All primary UCO cases were individually discussed and approved by the Ethics Committee as well. All patients who elected to undergo a primary UCO were considered eligible for this study.
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