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The outcomes of transient elevation of maternal liver enzymes preceding laser treatment for twin-twin transfusion syndrome

BACKGROUND: A proportion of twin-twin transfusion syndrome (TTTS) patients may have elevated liver enzymes (ELEzs) before fetoscopic laser therapy, but the incidence of ELEzs before laser therapy and the association with the perinatal outcomes after laser therapy remain unclear. METHODS: From Octobe...

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Autores principales: Chang, Yao-Lung, Chao, An-Shine, Chang, Shuenn-Dyh, Wang, Tzu-Hao, Cheng, Po-Jen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Chang Gung University 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6962711/
https://www.ncbi.nlm.nih.gov/pubmed/31948606
http://dx.doi.org/10.1016/j.bj.2019.05.006
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author Chang, Yao-Lung
Chao, An-Shine
Chang, Shuenn-Dyh
Wang, Tzu-Hao
Cheng, Po-Jen
author_facet Chang, Yao-Lung
Chao, An-Shine
Chang, Shuenn-Dyh
Wang, Tzu-Hao
Cheng, Po-Jen
author_sort Chang, Yao-Lung
collection PubMed
description BACKGROUND: A proportion of twin-twin transfusion syndrome (TTTS) patients may have elevated liver enzymes (ELEzs) before fetoscopic laser therapy, but the incidence of ELEzs before laser therapy and the association with the perinatal outcomes after laser therapy remain unclear. METHODS: From October 2008 to April 2015, 93 patients with TTTS who received fetoscopic laser therapy at our hospital were included in this study, and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were measured within 24 h before therapy. If ELEzs (AST > 34 U/L or ALT > 36 U/L) were observed before therapy, the AST and ALT levels were evaluated within 24 h after therapy. The pre-operative characteristics and post-therapy outcomes were compared between patients with and without ELEzs. RESULTS: Among 93 TTTS patients before laser operation, 18 patients (were found with ELEzs (19.4%) before laser therapy. In 17 (94.4%) of the 18 cases, their liver enzymes values dropped after laser surgery. Maternal body mass index, age, gestational age of laser therapy, hemoglobin level before laser therapy and survival rates after laser therapy were not significantly different between TTTS with and without ELEzs. The maternal hemoglobin dropped significantly from 10.8 [1.6] g/dL before surgery to 9.6 [1.5] g/dL after laser therapy in TTTS with ELEzs (p < 0.001). CONCLUSION: An elevated liver enzyme was not associated with poor perinatal outcomes in patients with TTTS after laser therapy. The authors suspected that the reduced liver enzymes values after laser therapy could partly arise from the hemo-dilution effect.
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spelling pubmed-69627112020-01-22 The outcomes of transient elevation of maternal liver enzymes preceding laser treatment for twin-twin transfusion syndrome Chang, Yao-Lung Chao, An-Shine Chang, Shuenn-Dyh Wang, Tzu-Hao Cheng, Po-Jen Biomed J Original article BACKGROUND: A proportion of twin-twin transfusion syndrome (TTTS) patients may have elevated liver enzymes (ELEzs) before fetoscopic laser therapy, but the incidence of ELEzs before laser therapy and the association with the perinatal outcomes after laser therapy remain unclear. METHODS: From October 2008 to April 2015, 93 patients with TTTS who received fetoscopic laser therapy at our hospital were included in this study, and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were measured within 24 h before therapy. If ELEzs (AST > 34 U/L or ALT > 36 U/L) were observed before therapy, the AST and ALT levels were evaluated within 24 h after therapy. The pre-operative characteristics and post-therapy outcomes were compared between patients with and without ELEzs. RESULTS: Among 93 TTTS patients before laser operation, 18 patients (were found with ELEzs (19.4%) before laser therapy. In 17 (94.4%) of the 18 cases, their liver enzymes values dropped after laser surgery. Maternal body mass index, age, gestational age of laser therapy, hemoglobin level before laser therapy and survival rates after laser therapy were not significantly different between TTTS with and without ELEzs. The maternal hemoglobin dropped significantly from 10.8 [1.6] g/dL before surgery to 9.6 [1.5] g/dL after laser therapy in TTTS with ELEzs (p < 0.001). CONCLUSION: An elevated liver enzyme was not associated with poor perinatal outcomes in patients with TTTS after laser therapy. The authors suspected that the reduced liver enzymes values after laser therapy could partly arise from the hemo-dilution effect. Chang Gung University 2019-12 2019-12-23 /pmc/articles/PMC6962711/ /pubmed/31948606 http://dx.doi.org/10.1016/j.bj.2019.05.006 Text en © 2019 Chang Gung University. Publishing services by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original article
Chang, Yao-Lung
Chao, An-Shine
Chang, Shuenn-Dyh
Wang, Tzu-Hao
Cheng, Po-Jen
The outcomes of transient elevation of maternal liver enzymes preceding laser treatment for twin-twin transfusion syndrome
title The outcomes of transient elevation of maternal liver enzymes preceding laser treatment for twin-twin transfusion syndrome
title_full The outcomes of transient elevation of maternal liver enzymes preceding laser treatment for twin-twin transfusion syndrome
title_fullStr The outcomes of transient elevation of maternal liver enzymes preceding laser treatment for twin-twin transfusion syndrome
title_full_unstemmed The outcomes of transient elevation of maternal liver enzymes preceding laser treatment for twin-twin transfusion syndrome
title_short The outcomes of transient elevation of maternal liver enzymes preceding laser treatment for twin-twin transfusion syndrome
title_sort outcomes of transient elevation of maternal liver enzymes preceding laser treatment for twin-twin transfusion syndrome
topic Original article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6962711/
https://www.ncbi.nlm.nih.gov/pubmed/31948606
http://dx.doi.org/10.1016/j.bj.2019.05.006
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