Intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome

Guidance issued

IP Guidance Number: IPG198

Summary:
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome.

Description:
Twin-to-twin transfusion syndrome occurs when unborn identical twins have different sacs in the womb but share the same placenta. This results in blood flow from one twin to the other through connections between blood vessels in the shared placenta becoming unbalanced. The volume of fluid around the twins also becomes uneven. This procedure is performed under regional analagesia or local anaesthesia with maternal sedation. Under ultrasound guidance, a cannula and needle are inserted through the maternal abdominal wall, uterine wall and into the amniotic sac of the recipient twin. The needle is removed, and a fetoscope with a thin fibre to carry the laser energy is then inserted through the cannula. The fetoscope is used to look at the blood vessels on the surface of the placenta. Vessels that are found to communicate between the twins are then coagulated using the laser. After completion of surgery, excess amniotic fluid in the recipient twin's sac is removed to achieve a normal volume.

Arrangements:

Other (see guidance)

Topic Area:

Gynaecology, pregnancy and birth

Specialty:

Obstetrics and gynaecology

Specialist advice has
been sought from:

British Association of Perinatal Medicine

British Maternal and Fetal Medicine Society

Royal College of Paediatrics and Child Health

Royal College of Obstetricians & Gynaecologists

Date notified to NICE:

01 April 2005

Provisional Consultation Date:

Autumn 2006

Guidance Publication Date:

13 December 2006

Contact Details:

Project Manager
(for general enquiries or comments)

Ben Doak

Technical Lead
(for procedure specific enquiries or comments)

Sally Wortley
ip@nice.org.uk

Contact Address:

Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA

Links:

	IPG198 Intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome - guidance	13 December 2006
	IPG198 Intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome - information for the public	13 December 2006
	IPG198 Intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome - information for the public (MS Word format)	13 December 2006
	Intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome (interventional procedures consultation)	29 August 2006
	Intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome (interventional procedures overview)	29 August 2006

Intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome

Search NICE guidance

Related information

Related guidance

Order NICE guidance

Navigation