Fetal Treatment Program of New England

Ongoing Studies

As a member of the North American Fetal Treatment Network (NAFTNet), our program participates in several multicenter clinical research studies.

  • Natural history of stage I twin-to-twin transfusion syndrome
    Currently, there is insufficient data regarding the behavior of twin-to-twin transfusion syndrome (TTTS) in its earliest stage. Some cases of TTTS reverse spontaneously; others progress to higher stages rapidly. To date, there are no known maternal or fetal factors that predict resolution or progression. Better defining the natural course of stage I TTTS could help identify patients who are more likely to progress to higher stages and how rapidly that progression may occur. In these cases, patients may benefit from definitive treatment such as laser photocoagulation, while the cases that are likely to resolve can be managed conservatively. The goals of this study are to better define the behavior of stage I TTTS, to address unanswered questions regarding disease management, and to identify demographic, sonographic and echocardiographic predictors of disease behavior.
  • Predictive markers in twin-to-twin transfusion syndrome
    Twin-to-twin transfusion syndrome (TTTS) occurs in 10 to 15% of pregnancies of identical twins. It is not yet clear why some cases evolve into TTTS and others do not. Furthermore, the evolution of the syndrome is highly variable and unpredictable. In some, TTTS progresses through increasing stages of severity within days; in others, the severity of the syndrome remains stable for weeks and may even decrease over time. The aim of the study is to develop tools to stratify patients into good and poor prognostic groups based on preoperative markers—including a corticotropin releasing hormone and urocortin, which are known factors associated with placental and fetal stress.
  • Indications for delivery after laser therapy for twin-to-twin transfusion syndrome
    Complications of prematurity remain a major source of morbidity among infants treated for twin-to-twin transfusion syndrome (TTTS) in utero by selective fetoscopic laser photocoagulation of placental vessels. Studies involving treatment of TTTS have significant heterogeneity of gestational age at delivery. There is insufficient data regarding the proportion of spontaneous versus preterm birth following preterm premature rupture of membranes versus clinically indicated delivery. This information would help parents decide on a preferred treatment course and help physicians determine the timing of delivery. The purpose of this study is to determine the indications for delivery for TTTS after treatment with selective fetoscopic laser photocoagulation.

To learn more about any of our ongoing studies or to find out if you qualify, please contact our coordinator at [email protected].