Trends in mode of delivery of infants with congenital heart disease: 224

Abstract

respectively. 7 (4.8%) had a preoperative cervical length (CL) <25mm. All patients elected Solomon FLOC; complete outcome was obtained for 140 pregnancies. Intraoperative intentional septostomy was less frequent in our cohort (7 (5%) vs. 17 (12%); p1⁄40.024) but rupture of membranes (PPROM) within 2 weeks of FLOC was similar (6 (4%) vs 4 (3%); p1⁄40.27). PPROM at birth was seen in 26 (18%) (vs. 57 (42%); p<0.005, Table). Recurrent TTTS (n1⁄42, 1%) and Twin anemia polycythemia sequence (n1⁄43, 2%) requiring repeat FLOC was similar to the Solomon-RCT rate. Median FLOC to delivery interval was 78.5 days (0-141) resulting in a delivery gestational age of 32.2 weeks (range 18+5 e 38+0). Pre-FLOC CL was unrelated to the interval to delivery (Pearson 0.12, p1⁄40,331; median interval 61 vs 82 days for CL<25 and above respectively, p1⁄40.492). Overall twin survival was significantly higher due to a larger proportion of double twin survival at birth (104 74% vs 87 (64%), p<0.05, Table). CONCLUSION: Solomon FLOC offered in a clinical setting performs at least as well as anticipated from the randomized trial with superior outcomes compared to any other treatment. In the absence of any absolute contraindication Solomon FLOC should be offered to all TTTS patients irrespective of disease severity.