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Outcomes Data: Laser Ablation for Twin-Twin Transfusion Syndrome

Twin-Twin Transfusion Syndrome (TTTS) – Experience Matters

The Fetal Center at Children’s Memorial Hermann Hospital utilizes the experience and expertise of the internationally recognized team of affiliated fetal surgeons to provide the highest level of care to patients. As a national referral program, The Fetal Center currently receives patient referrals from 36 states and continues to serve as a leader in fetal diagnosis, fetal intervention and comprehensive fetal care for unborn babies with abnormalities. Click here to learn more.

Below is an overview of The Fetal Center’s clinical outcomes data for the treatment of TTTS. We strive to provide our patients and community with the most up-to-date information on our patient outcomes. Our hope is that the below data serves as a helpful resource to you when making informed decisions regarding your care.

For more information about our data, contact The Fetal Center, at (832) 325-7288.

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Overall Summary

Since 2011, The Fetal Center has performed 444 cases of laser photocoagulation for the treatment of TTTS at Children’s Memorial Hermann Hospital. The data below reflects surgical volume from September 2011 – October 2018 and represents 392 patients with known outcomes at 30 days post-delivery.

Overall, survival of both babies is seen in 73 percent of cases, with survival of one twin in 15 percent of cases.

Total Number of Laser Case Procedures:444
Number of Laser Repeat Cases6
Number of Twin Pregnancies425
Number of Deliveries397
Number of Deliveries with Known 30-Day Outcome392
TTTS 30-Day Post-Delivery Survival Rate by Gestational Age at Time of Fetal Intervention
Gestational Age at time of ProcedureTotalPregnancies with Twin SurvivorsPregnancies with One Twin SurvivorPregnancies with No Survivors
16 - 18 weeks1117366%2321%1514%
19 - 21 weeks16212678%149%2214%
22 - 24 weeks876372%1517%910%
25 - 27 weeks 312374%826%0--
28 + weeks10--1100%0--
SUMMARY39228573%6115%4312%

30-Day Post-Delivery Survival Rate by TTTS Stage

The tables below reflect surgical volume from September 2011 – October 2018 and represents data from 392 patients with known outcomes at 30 days post-delivery.

30-Day Post-Delivery Survival Rate by TTTS Stage
TTTS StageCases (percent of total cases*)Pregnancies with Twin SurvivorsPregnancies with One Twin SurvivorPregnancies with No Survivors
Stage I49 (13%)86%10%4%
Stage II115 (29%)75%11%14%
Stage III210 (54%)68%19%13%
Stage IV 17 (4%)76%18%6%
*TTTS Stage was undetermined in one case, which represents 0.26% of known outcomes.

TTTS 30-Day Post-Delivery Survival Rate by Cervical Length

The Fetal Center is committed to a highly aggressive approach to the overall survival of all twin pregnancies, treating some of the rarest and high risk cases – including mothers with a cervical length of less than 1.5 cm, which increases a mother’s risk of spontaneous preterm birth by almost 50 percent, according to the American Journal of Obstetrics and Gynecology.

The below data reflects surgical volume from September 2011 – October 2018. The data represents 390 patients with known outcomes at 30 days post-delivery, specifically highlighting outcomes based on mothers’ cervical length. As noted below, a cervical length of ≥ 1.5 cm was found in 95% of cases at The Fetal Center.

TTTS 30-Day Post-Delivery Survival Rate by Cervical Length
 Number of Cases*Pregnancies with Twin SurvivorsPregnancies with One Twin SurvivorPregnancies with No Survivors
Number of cases with Cervical Length ≥ 1.5 cm371277(75%)57(15%)3710%
Number of cases with Cervical Length ‹ 1.5 cm197(37%)3(16%)9(47%)
Total390284(73%)60(15%)46(12%)
*Cervical length was undetermined in two cases.

Note – Those with a cervical length of less than 1.5cm are at increased risk and should be seen by a physician as soon as possible. Please call The Fetal Center at (832) 325-7288.

The data represents patient volume from September 2011 through October 2018. Published November 2018.

We encourage you to reach out to other health care centers to request and review their outcomes data in order to utilize the information available when choosing your health care options.

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If you have any questions, use the online tool below to help us connect with you. To refer a patient or schedule an appointment, please contact our clinic using the information below.

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UT Professional Building
6410 Fannin, Suite 210
Houston, Texas 77030
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For more information about our data, contact The Fetal Center, at (832) 325-7288
Toll free: (888) 818-4818
Fax: (713) 383-1464
Email: thefetalcenter@memorialhermann.org