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Laser Ablation for Twin-Twin Transfusion Syndrome Outcomes

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.

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

For more information or to speak with a clinician at The Fetal Center, call (832) 325-7288 or email thefetalcenter@memorialhermann.org.

Overall Summary

Since 2011, The Fetal Center has performed 374 cases of laser photocoagulation for the treatment of TTTS at Children’s Memorial Hermann Hospital. The data below reflects surgical volume from September 2011 – August 1, 2017 and represents 323 patients with known outcomes at 30 days post-delivery.

Overall, survival of both babies is seen in 72 percent of cases, with survival of one twin in 15 percent of cases.

Total Number of Laser Case Procedures:374
Number of Laser Repeat Cases3
Number of Twin Pregnancies356
Number of Deliveries330
Number of Deliveries with Known 30-Day Outcome323
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 weeks895865%1820%1315%
19 - 21 weeks13210177%118%2015%
22 - 24 weeks755675%1114%811%
25 - 27 weeks 271970%830%0--
SUMMARY32323472%4815%4113%

30-Day Post-Delivery Survival Rate by TTTS Stage

The below data reflects surgical volume from September 2011 – August 1, 2017 and represents data from 323 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 I43 (13%)84%11%5%
Stage II96 (30%)76%9%15%
Stage III166 (51%)68%18%14%
Stage IV 15 (5%)67%26%7%
*TTTS Stage was undetermined in three cases, which represents 1% of known outcomes.

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

In order to give patients the best chance for a positive outcome relevant to the severity of their condition, The Fetal Center is committed to a highly aggressive approach to the overall survival of all twin pregnancies. We treat 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.

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 below data reflects surgical volume from September 2011 – August 1, 2017. The data represents 322 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 cm30622674%4715%3311%
Number of cases with Cervical Length ‹ 1.5 cm16744%212%744%
Total32223372%4915%4013%
*Cervical length was undetermined in one case.
The data represents patient volume from September 2011 through August 1, 2017.
Published August 2017.

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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