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OP23.01: Cardiac function assessed by tissue Doppler myocardial velocities in fetuses with growth restriction

gestation who underwent fetoscopic laser surgery at four centers in Japan. We assessed perinatal survival, survival at 6 months of age, and neurological complications. A conditional logistic regression was performed using preoperative ultrasonographic variables to estimate adjusted odds ratios (OR) for fetal or neonatal death. Results: Survival of at least one twin at 28 days and 6 months of age were 91.2% and 90.1%, respectively. Survival at 6 months of age without major neurological complications was 72.4%. There were no differences in at least one survivor at 28 days of gestation between Quintero stage 1 or 2 (90.9%) and 3 or 4 (91.2%). However, two survivors at 28 days of gestation were significantly lower in Quintero stage 3 or 4 (59.1%) than 1 or 2 (81.8%). The significant independent variables of the preoperative ultrasound findings for fetal or neonatal death of the donor were reversed (OR: 9.29, 95% confidence interval (CI): 2.86–30.14) or absent (OR: 3.87, CI: 1.81–8.29) end-diastolic velocity in the umbilical artery, and reversed blood flow in the ductus venosus (OR: 2.45, CI: 0.41–14.64) of the donor. Those for neonatal death of the recipient were reversed blood flow in the ductus venosus (OR: 2.25, CI: 0.95–5.34) and hydrops of the recipient (OR: 2.14, CI: 0.76–6.05). Conclusions: Survival of at least one twin after fetoscopic laser surgery reached 90%, regardless of the stage. Two survivors were decreased in Quintero stage 3 or 4. Reversed or absent end-diastolic velocity in the umbilical artery of the donor, reversed blood flow in the ductus venosus of the donor or recipient, and hydrops of the recipient were associated with one fetal and one neonatal death.