2026-04-17T19:12:25Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/58862025-10-24T10:30:58Zcom_2072_378070com_2072_378040col_2072_378092

Arabin cervical pessary for prevention of preterm birth in cases of twin-to-twin transfusion syndrome treated by fetoscopic LASER coagulation: the PECEP LASER randomised controlled trial Rodó Rodríguez, Carlota Lewi, Liesbeth Hecher, Kurt Carreras Moratonas, Elena Arévalo Martínez, Silvia Couck, Isabel Hollwitz, Bettina Institut Català de la Salut [Rodó C, Arévalo S, Carreras E] Unitat de Medicina Fetal, Servei d’Obstetrícia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Lewi L, Couck I] Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium. Department of Development and Regeneration, KU Leuven, Leuven, Belgium. [Hollwitz B, Hecher K] Department of Obstetrics and Prenatal Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany Vall d'Hebron Barcelona Hospital Campus Infants prematurs Sang - Coagulació Fetus - Cirurgia DISEASES::Female Urogenital Diseases and Pregnancy Complications::Pregnancy Complications::Obstetric Labor Complications::Obstetric Labor, Premature::Premature Birth ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Therapeutics::Laser Therapy::Laser Coagulation ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Surgical Procedures, Operative::Obstetric Surgical Procedures::Fetoscopy ENFERMEDADES::enfermedades de los genitales femeninos y complicaciones del embarazo::complicaciones del embarazo::complicaciones del parto::parto prematuro::nacimiento prematuro TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::terapéutica::tratamiento con láser::coagulación con láser TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::intervenciones quirúrgicas::procedimientos quirúrgicos obstétricos::fetoscopia Cervical pessary; Fetoscopic LASER coagulation, Twin-to-twin transfusion syndrome Pessari cervical; Coagulació làser fetoscòpica; Síndrome de transfusió bessó a bessó Pesario cervical; Coagulación láser fetoscópica; Síndrome de transfusión de gemelo a gemelo Background Fetoscopic LASER coagulation of the placental anastomoses has changed the prognosis of twin-twin transfusion syndrome. However, the prematurity rate in this cohort remains very high. To date, strategies proposed to decrease the prematurity rate have shown inconclusive, if not unfavourable results. Methods This is a randomised controlled trial to investigate whether a prophylactic cervical pessary will lower the incidence of preterm delivery in cases of twin-twin transfusion syndrome requiring fetoscopic LASER coagulation. Women eligible for the study will be randomised after surgery and allocated to either pessary or expectant management. The pessary will be left in place until 37 completed weeks or earlier if delivery occurs. The primary outcome is delivery before 32 completed weeks. Secondary outcomes are a composite of adverse neonatal outcome, fetal and neonatal death, maternal complications, preterm rupture of membranes and hospitalisation for threatened preterm labour. 352 women will be included in order to decrease the rate of preterm delivery before 32 weeks’ gestation from 40% to 26% with an alpha-error of 0.05 and 80% power. Discussion The trial aims at clarifying whether the cervical pessary prolongs the pregnancy in cases of twin-twin transfusion syndrome regardless of cervical length at the time of fetoscopy. 2021-04-21T13:02:52Z 2021-04-21T13:02:52Z 2017-08-01 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Rodó C, Arévalo S, Lewi L, Couck I, Hollwitz B, Hecher K, et al. Arabin cervical pessary for prevention of preterm birth in cases of twin-to-twin transfusion syndrome treated by fetoscopic LASER coagulation: The PECEP LASER randomised controlled trial. BMC Pregnancy Childbirth. 2017 Aug 1;17(1):256. 1471-2393 https://hdl.handle.net/11351/5886 10.1186/s12884-017-1435-0 28764674 000406691700003 http://hdl.handle.net/11351/5886 eng BMC Pregnancy and Childbirth;17 (1) http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1435-0 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf BMC Scientia