P07.05: Twin–twin transfusion syndrome in patients with suspected shared umbilical cord insertion into the placenta

We experienced three cases of Twin–twin transfusion syndrome (TTTS) in which preoperative ultrasonography demonstrated that the cord insertion sites of twins were close. Two cases were successfully treated with fetoscopic laser photocoagulation (FLP); however, the third case could not be treated surgically because fetoscopy revealed that cord insertions formed a “v-shaped” joint above the placenta and that all chorionic vessels of the placental surface were shared by the twins. No residual anastomoses were detected on a placental examination in two cases after FLP. Our experiences indicated that the feasibility of FLP could be evaluated using fetoscopy, not just ultrasonography, in cases of TTTS accompanied by proximate umbilical cord insertion.