What intervention is suggested for Stage II, III, and IV TTTS before 26 weeks?

Fetoscopic laser photocoagulation is the recommended intervention for Stage II, III, and IV Twin-to-Twin Transfusion Syndrome (TTTS) before 26 weeks of gestation. This procedure involves the use of a laser to selectively coagulate the placental vessels that are causing the abnormal blood flow between the twins. By targeting the specific blood vessels responsible for the imbalance in circulation, this intervention aims to normalize blood flow dynamics and significantly improve outcomes for both fetuses.

This approach is particularly effective in addressing the complications associated with TTTS, such as cardiac overload in the recipient twin and growth restriction in the donor twin. It is a minimally invasive technique that has been shown in studies to reduce the risks of preterm birth and improve survival rates compared to conservative management options.

In contrast, antenatal monitoring alone does not provide any therapeutic benefit and simply involves observing the condition without intervention. Administering blood transfusions may temporarily address some symptoms, but it does not tackle the underlying issue of vascular malformation. Immediate cesarean delivery is usually reserved for specific urgent situations rather than being a standard intervention for TTTS. Overall, fetoscopic laser photocoagulation stands out as the most effective management strategy for this condition at the specified gestational