Laser coagulation in complicated monochorionic pregnancies

• Autores: Gergana Peeva
• Directores de la Tesis: Kypros H. Nicolaides (dir. tes.), María de la Calle Fernández-Miranda (dir. tes.)
• Lectura: En la Universidad Autónoma de Madrid ( España ) en 2018
• Idioma: español
• Número de páginas: 119
• Tribunal Calificador de la Tesis: José Luis Bartha Rasero (presid.), Eugenia Antolín Alvarado (secret.), María del Mar Gil Mira (voc.), Jacques Jani (voc.), Francisca Sonia Molina García (voc.)
• Programa de doctorado: Programa de Doctorado en Medicina y Cirugía por la Universidad Autónoma de Madrid
• Materias:
  • Ciencias tecnológicas
    • Tecnología electrónica
      • Dispositivos láser
• Enlaces
  • Tesis en acceso abierto en: Biblos-e Archivo
• Resumen

  • Monochorionic pregnancies are found in 1 in 200 births, but the incidence is increasing because of the widespread use of assisted reproductive technology.

    Monochorionic twins, compared to dichorionic twins, have a considerably higher risk of pregnancy complications that are dues to the process of splitting of the single embryonic mass [congenital abnormalities, conjoint twins, selective fetal growth restriction (sFGR)] and the communicating placental vessels between the two circulations [twin-to-twin transfusion syndrome (TTTS), twin reversed arterial perfusion (TRAP) sequence, twin anemia polycythemia sequence (TAPS)].

    This thesis reports on the outcome of pregnancies with sFGR (with and without superimposed TTTS) treated by endoscopic laser separation of the inter-twin communicating placental vessels.

    Triplet pregnancies in which two or all three fetuses are monochorionic, are at very high risk of perinatal death. The incidence of dichorionic triamniotic pregnancies has dramatically increased following the practice of IVF with delayed transfer of two embryos.

    This thesis reports on the outcome of monochorionic and dichorionic triplet pregnancies complicated by TTTS (with and without sFGR) treated by endoscopic laser separation of the communicating placental vessels. The thesis also reports on the development of a first-trimester technique for embryo reduction of one of the two monochorionic twins by ultrasound-guided interstitial laser ablation of the pelvic vessels