Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

OBJECTIVES: The introduction of fetoscopic laser surgery of placental anastomoses has led to a significant improvement of perinatal outcome of twin pregnancies affected by twin-to-twin-transfusion syndrome (TTTS). To quantify the perinatal outcome and neurological morbidity in triplet pregnancies complicated by TTTS, which were treated with fetoscopic laser surgery. SEARCH STRATEGY: Medline, Embase, Cinahl and Cochrane were searched. SELECTION CRITERIA: The outcomes observed were: fetal and perinatal survival, preterm birth and abnormal neurological outcome. DATA COLLECTION AND ANALYSIS: Two authors reviewed all abstracts independently. Meta-analyses of proportions were used to combine data. MAIN RESULTS: Eight studies (126 triplet pregnancies, 104 dichorionic-triamniotic [DCTA] and 22 monochorionic-triamniotic [MCTA]) treated with fetoscopic laser surgery were included in this review. In DCTA and MCTA pregnancies, fetal losses were 18.9% and 28.9%, respectively; perinatal losses were 23.6% and 75.0%; preterm births <28 weeks of gestation were 16.9% and 37.1%; preterm births <32 weeks of gestation were 50.0% and 69.5%; at least one fetus survived in 95.4% and 88.9% of the pregnancies; at least two fetuses survived in 81.8% and 68.3% of the pregnancies; and in 55.9% and 48.4% pregnancies all triplets survived. Finally, the incidence of abnormal neurological outcomes ranged from 0 to 37% in DCTA and from 0 to 50% in MCTA triplets. CONCLUSIONS: Both DTCA and MCTA triplet pregnancies affected by TTTS are at high risk of adverse perinatal outcome. TWEETABLE ABSTRACT: Both DTCA and MCTA triplet pregnancies affected by TTTS are at high risk of adverse perinatal outcome.

Original publication




Journal article



Publication Date





328 - 336


Outcome, triplet pregnancies, twin-to-twin transfusion syndrome, Female, Fetofetal Transfusion, Fetoscopy, Humans, Infant, Newborn, Laser Therapy, Pregnancy, Pregnancy Outcome, Pregnancy, Triplet