Risks of Preterm Premature Rupture of Membranes and Preterm Birth Post Fetoscopy Based on Location of Trocar Insertion Site

Objective  The objective of this study was to assess whether the location of the trocar insertion site for laser treatment of twin-twin transfusion syndrome was associated with preterm-premature rupture of membranes (PPROM) and preterm birth (PTB). Study Design  In this study trocar location was documented in the operating room. Lower uterine segment (LUS) location was defined as any insertion Results  A total of 743 patients were studied. Patients with LUS location were twice as likely as those with a more superior location to have PPROM ≤ 21 days (OR = 2.33, 1.12–4.83, p  = 0.0236). Patients with both a LUS and Lateral location were over six times more likely to have PPROM ≤ 21 days (OR = 6.66, 2.36–18.78, p  = 0.0003). Trocar insertion site was not associated with PTB. Conclusion  We found that trocar insertion in the LUS, particularly the lateral LUS, was associated with an increased risk of PPROM.