The experience of women receiving maternal-fetal surgery for twin-twin transfusion syndrome
Background: Treatment for twin-twin transfusion syndrome (TTTS) includes selective laser photocoagulation (LPC) of placental anastomoses. The experience of women who receive this treatment has received limited attention. Aim: The aim of this study was to explore the experience of women who received laser photo coagulation of placental anastomoses (LPC) for a pregnancy complicated by twin-twin transfusion syndrome (TTTS). Method: A qualitative study, using interpretive description methods, consisting of two in-depth, semi-structured interviews, one before and one after LPC procedure, was conducted with 14 women, pregnant with monochorionic-diamniotic twin pregnancies complicated with TTTS, in a large, urban, university affiliated specialty clinic and hospital. Content analysis of data was accomplished utilizing descriptive coding to categorize exemplars to illustrate emergent themes. Inductive analysis was used to identify the emergent themes. Findings: There were two major themes: 1) uncertainty of outcome, related to the status the babies' health and the progression of TTTS; and 2) dissonance of understanding, related to the differences between the expectations for the pregnancy and the reality of the TTTS. Pre-procedure contributing factors that contributed to the uncertainty and dissonance included: 1) condition and TTTS staging of the babies; 2) participants' perceptions of inconsistencies of information; 3) maternal feelings of helplessness; 4) parenting behaviors; and 5) spousal, family, and other support. Contributing factors changed after the LPC procedure and included: 1) perception of well-being; 2) lifestyle changes; 3) parenting plans; and 4) support. Conclusions: Women who undergo LPC for TTTS experience uncertainty and dissonance based on their babies' conditions and the possible outcomes of the procedure that lead to maternal distress in coping with their pregnancies. Implications: Nursing interventions of compassionate and supportive care are essential to enable these women and their families to have a meaningful experience of pregnancy. Key Words: twin-twin transfusion syndrome, laser photo coagulation, maternal experience.
Emerson, Patricia, "The experience of women receiving maternal-fetal surgery for twin-twin transfusion syndrome" (2013). Texas Medical Center Dissertations (via ProQuest). AAI3574413.