OC18.01: Stage‐based outcomes for 400 cases of <scp>TTTS</scp> managed with fetoscopic laser ablation of placental anastomoses
Bibliographic record
Abstract
To examine stage-based perinatal outcomes in all cases of Twin–twin transfusion syndrome (TTTS) undergoing fetoscopic laser ablation of placental anastomoses at our fetal medicine unit. Demographics, ultrasound findings, Quintero staging, surgical characteristics and neonatal survival were prospectively collected from 1998 to 2014. Triplets were excluded. A total of 400 consecutive cases of Twin–twin transfusion syndrome (TTTS) managed by fetoscopic selective laser ablation of placental anastomoses at our centre were included. Median gestational age of surgery was 21.0 (14–30) weeks, with a median gestational age at delivery of 32.1 (16–40) weeks. Within 7 days post laser, 8% had preterm premature rupture of membranes and 7.5% had preterm delivery. The median time interval between laser therapy and delivery was 10.7 (0–22) weeks. Survival at 6 months of life of both twins was 58.3%, although outcomes were poorest for stage 3 donor (3D) (37.0% dual survival). Specifically, survival was 69%, 65%, 62%, 37%, 63% and 54% for stage 1, 2, 3R, 3D, 3R + D and 4 respectively. Survival of at least one twin at 6 months of age was 87.2% for all stages combined and 88.0% after excluding stage 3D and thus, was independent of TTTS staging. Based on our experience, parents can be counselled that dual survival at 6 months is 58% across all stages of TTTS, although it is lowest for stage 3D, reflecting the challenges we face when managing TTTS with concomitant selective fetal growth restriction.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.034 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| 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) | 0.000 | 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 teacher head, 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".