Fetal Doppler changes 1 week after endoscopic equatorial laser for twin‐to‐twin transfusion syndrome: A longitudinal study

Objective To investigate sequential Doppler changes in donors and recipients before and 1 week after endoscopic laser for twin‐to‐twin transfusion syndrome (TTTS) and to examine factors that may be associated with such changes. Methods In TTTS pregnancies undergoing laser treatment, we examined fetal Doppler changes before and 1 week postintervention. Intrauterine death rates and preoperative factors were analyzed in relation to Doppler changes. Results Among 129 (85.4%) donors surviving at 1 week after laser, there was normalization of umbilical artery flow in 26 (72.2%) of 36 cases with preoperative abnormal Dopplers. In the remaining 10 (27.8%) fetuses, abnormal findings persisted. The rate of later intrauterine death was significantly higher in the latter group (6 of 10, 60.0%) compared with fetuses in which Doppler findings normalized (4 of 26, 15.4%; P