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Revista chilena de obstetricia y ginecología

versión On-line ISSN 0717-7526

Resumen

MOLINA G, Saulo; CASAS P, Rodolfo  y  ORTIZ M, Roberth. Resultados perinatales en el síndrome de transfusión feto fetal manejados con la técnica de Solomon: Revisión de la literatura. Rev. chil. obstet. ginecol. [online]. 2016, vol.81, n.3, pp.234-242. ISSN 0717-7526.  http://dx.doi.org/10.4067/S0717-75262016000300011.

Introduction: Between 15 to 20% of monochorionic diamniotic twin pregnancies are complicated by the twin-twin transfusion syndrome. It has a mortality greater than 90% and a significant morbidity, 50% in the surviving twin. The Solomon technique (laser photocoagulation of the main vascular channels of the chorio-nic plate surface along the entire vascular equator) has been suggested to reduce the recurrence, and pre-vent secondary complications without increasing adverse results. Methods: Systematic review of electronic searches of the literature from 2000 to 2015 (MEDLINE, EBSCO, OVID, PROQUEST, COCHRANE, Lilacs, and SciELO). We included review articles and original investigations comparing the standard photocoagulation technique with laser ablation against the Solomon technique. The primary results were reduction of Anemia Polycythemia Sequence incidence, twin-twin transfusion syndrome recurrence, perinatal mortality and severe neonatal morbidity. Results: Of 200 articles, we selected six: one clinical essay and its secondary analysis, two retrospective cohort studies, one systematic review and a study comparing neurodeve-lopmental outcomes. The studies suggested a survival improvement in some fetuses using the Solomon technique, less twin-twin transfusion syndrome recurrence and Anemia Polycythemia Sequence without the presence of adverse effects. Conclusión: Solomon technique improves the survival of some twins, although we cannot conclude there is mortality improvement, because the studies do not have enough power to determine that.

Palabras clave : Laser surgery; fetoscopy; monochorionic twins; twin-twin transfusion syndrome; twin anemia-polycithemia sequence; twin oligo-polyhydramnios sequence.

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