Current evidence on the safety and efficacy of intrauterine laser ablation of placental vessels for the treatment of twin-to-twin transfusion syndrome (TTTS) appears adequate to support the use of this procedure provided that the normal arrangements are in place for clinical governance.
Clinicians wishing to undertake intrauterine laser ablation of placental vessels for the treatment of TTTS should ensure that parents understand that in spite of intrauterine laser ablation treatment, there is still a risk that one or both twins may not survive. A risk remains of serious abnormalities in the development of the nervous system among survivors of TTTS. Clinicians should provide parents with clear written information. In addition, use of NICE's information for the public is recommended.
Clinicians should consider case selection carefully because there are uncertainties about the stages of TTTS for which this procedure is appropriate.
This procedure should only be performed in centres specialising in invasive fetal medicine and by an appropriately constituted multidisciplinary team.
Clinicians are encouraged to collaborate on longer-term data collection across the centres performing intrauterine laser ablation for the treatment of TTTS. NICE may review the procedure upon publication of further evidence.