Perioperative Care of Patients Diagnosed With Twin‐to‐Twin Transfusion Syndrome Undergoing Laparoscopic‐Assisted Fetoscopic Placental Laser Photocoagulation. (31st March 2021)

• Record Type: Journal Article
• Authors: Cunningham, Thomas; Anthony Canedo, Danny; Ibanez, Danielle; Arroyo Papel, Liezel; Dungo, Nerissa; Cordero, Amber; Graves, Krisanne
• Is Part Of: AORN journal. Volume 113:Number 4(2021)
• Page Start: 361
• Page End: 372
• Publication Date: 2021-03-31
• Subjects: monochorionic diamniotic (MCDA) twin pregnancy -- twin-to-twin transfusion syndrome (TTTS) -- fetoscopic placental laser photocoagulation (FPLP) -- placentation -- laparoscopic‐assisted approach; Operating room nursing -- Periodicals; Soins infirmiers en salle d'opération -- Périodiques; Nursing -- Periodicals; Operating Room Nursing -- Periodicals; Perioperative Nursing -- Periodicals; Societies, Nursing -- Periodicals; 617.917
• DOI: 10.1002/aorn.13354
• Languages: English
• ISSNs: 0001-2092

Abstract

ABSTRACT: Twin‐to‐twin transfusion syndrome (TTTS) is a condition that results in unbalanced blood flow between two fetuses. Patients diagnosed with TTTS can experience maternal or fetal morbidity and mortality. Depending on the severity of TTTS, laser ablation of placental anastomoses may be the most effective treatment. The preferred treatment method requires percutaneous entry to the uterus; however, some patient circumstances (eg, placenta location) require a laparoscopic‐assisted procedure. During the preoperative appointments, clinicians assess the condition of the fetuses and patients may participate in genetic counseling. Intraoperative care involves an interdisciplinary team that may include a pediatric general surgeon, maternal‐fetal medicine specialists, an RN circulator, a scrub person, and an anesthesia professional. Perioperative nurses should have knowledge of the pathophysiology of TTTS, including its natural progression. They also should understand preoperative and intraoperative patient care requirements to provide safe and effective care for patients undergoing laparoscopic‐assisted fetoscopic placental laser photocoagulation procedures.