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Rejoinder to Meta-Analysis of Twin-Twin Transfusion by Skupski et al.

Published online by Cambridge University Press:  21 February 2012

Geoffrey A. Machin*
Affiliation:
The Permanente Medical Group, Oakland, California, USA. [email protected]
*
*Address for correspondence: Geoffrey A Machin, MD, Department of Pathology, Kaiser Oakland Medical Center, 280 West MacArthur Blvd, Oakland CA 94611, USA.

Abstract

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Assessment of treatment options in twin-twin transfusion should involve a detailed interrogation of the placenta and fetuses prior to treatment, stratification according to response to amnioreduction and careful analysis of quality of survival. Amnioreduction and laser coagulation are not alternative and equivalent modalities for the treatment of twin-twin transfusion. Randomized trials may not be ethical without prior therapeutic/ diagnostic amnioreduction.

Type
Articles
Copyright
Copyright © Cambridge University Press 2002