P09.15: Fetoscopic laser surgery for twin‐to‐twin transfusion syndrome before 17 and after 26 weeks gestation
Bibliographic record
Abstract
Fetoscopic laser ablation of vascular anastomoses in twin-to-twin transfusion syndrome (TTTS) is routinely performed between 16 and 26 wks gestation. Limited data are available for early (< 17 wks) or late (> 26 wks) laser therapy for TTTS. The objective was to compare the outcomes of early and late fetoscopic laser for TTTS with those treated between 17–26 wks gestation. 24 “early” cases (14.6–17 wks) and 18 “late” (26–30.3 wks) cases of TTTS treated with laser were compared with 283 cases treated between 17–26 wks (“conventional”) in one center. Maternal demographic data, Quintero stage, fetoscopy duration, complications (preterm labor < 28 wks, PPROM < 7 days, delivery < 7 days, intra-uterine death < 7 days), gestation at delivery and neonatal survival were compared. Study groups were similar in terms of maternal age, parity, Quintero staging and frequency of an anterior placenta. Comparing “conventional” to “early” and “late” cases, there were no significant differences in fetoscopy duration (57 min, 53 min. [P = 0.5], 58 min. [P = 0.8]), delivery < 28 wks (23%, 17%, 17%, P = 0.8), gestation at delivery (30, 29, [P = 0.2], 32 wks [P = 0.3]), survival of at least one twin (86%, 79% [P = 0.4], 92% [P = 0.5]) and dual survival (56%, 53% [P = 0.8], 71% [P = 0.2]). The earlier the laser was performed, the longer was the laser-to-delivery interval (10, 14 [P = 0.002], 6 wks [P = 0.003]). However, PPROM < 7 days post-laser occurred significantly more often in the early laser group (25% “early” [P = 0.01], 6% “conventional”, 6% “late” [P = 0.9]), although this was not significant for PPROM < 10 days. Eight lasers were performed < 16 wks in our center. None of them delivered < 7 days and only 2 delivered before 26 weeks. Fetoscopic laser for TTTS performed < 17 wks or after 26 wks gestation is associated with similar outcomes to cases treated between 17 to 26 weeks. We suggest that “arbitrary” cut offs for laser therapy of 16 or 26 wks should be reconsidered.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".