Predictors of fetal death, neonatal survival and neurological outcomes in severe twin‐twin transfusion syndrome treated by laser ablation of placental vessels

Objectives To identify predictors of outcomes in severe twin oligo‐polyhydramnios sequence (TOPS) with or without twin anemia‐polycythemia sequence (TAPS) and/or selective fetal growth restriction (SFGR) treated by laser ablation of placental vessels (LAPV). Methods Analysis of cases treated from 2011 to 2022. Variables evaluated Prenatal predictors: stages of TOPS, presence of TAPS and/or SFGR; pre‐LAPV fetal ultrasound parameters; peri‐LAPV variables. Perinatal predictors: GA at birth; birthweight; Apgar scores; transfontanellar ultrasonography (TFUS). Outcome variables: fetal death, neonatal survival, infant's neurodevelopment. Binary logistic regression analyses were performed to detect predictors of outcomes. Results 265 cases were included. Predictors of post‐LAPV donor fetus' death were delta EFW (p:0.045) and absent/reverse end‐diastolic flow in the umbilical artery (AREDF‐UA) (p