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Perinatal outcomes of iatrogenic chorioamniotic separation following fetoscopic surgeries: A systematic review and meta‐analysis

Ultrasound in Obstetrics & Gynecology Jan 17, 2021

Nassr AA, Hessami K, Shazly SA, et al. - Researchers aimed at comparing the perinatal outcomes of pregnancies with and without iatrogenic chorioamniotic separation (iCAS) after fetoscopic interventions via performing a systematic review and meta‐analysis. Searching PubMed, Embase, Scopus, Web of Science and Google Scholar, they identified 348 records. Of these, seven studies (6 on twin to twin transfusion syndrome (TTTS) and 1 on open neural tube defects fetoscopic repair) reported perinatal outcome of iCAS pregnancies after fetoscopic interventions. Findings suggest that after fetoscopic laser photocoagulation for TTTS, iatrogenic chorioamniotic separation is a commonly recorded complication. In the TTTS patients, higher tendency to develop iCAS was observed in correlation with earlier gestational age (GA) at intervention and its occurrence is linked with earlier GA at delivery, higher risk of PPROM, preterm delivery before 32 weeks’ gestation and lower neonatal survival. Given the limitations of this meta‐analysis and lack of literature reporting on other types of fetoscopic interventions, they emphasize interpreting the presented findings with caution and not generalizing these to fetoscopic procedures used to treat other fetal conditions.

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