Evaluation of long-term neurodevelopment in twin-twin transfusion syndrome after laser therapy.

Abstract:

OBJECTIVE:The primary objective of our study was to evaluate the long-term neurodevelopment outcome after laser surgery for twin-twin transfusion syndrome (TTTS). The secondary objective was to identify perinatal prognostic factors associated with neurodevelopmental impairment. METHOD:This was a single-center cohort prospective study carried out in pregnancies complicated by TTTS and treated by laser. Neurodevleopmental assesment included the administration of Ages and Stages Questionnaires® (ASQ), for the infants between 2 and 5 years of age. RESULTS:A total of 187 patients underwent a laser for TTTS between 2004 and 2013. Significant brain lesions were detected in eight (2.9%) cases by ultrasound and/or magnetic resonance imaging including intraventricular hemorrhage, periventricular leukomalacia, and porencephaly. Questionnaires were administered to 126 children (50.4%) at 24 months or older at the moment of testing. There were 13.5% of those infants who had an abnormal ASQ (established as one area or more scoring < 2 SD) at 3.6 years ±1.3 follow-up. There was a higher rate of abnormal ASQ among the infants with a birth weight below the fifth percentile (p = 0.036). CONCLUSION:Twin-twin transfusion syndrome is associated with a risk of abnormal neurological development, even in case of laser surgery. Further studies are necessary to identify the risk factors for neurological impairment. © 2016 John Wiley & Sons, Ltd.

journal_name

Prenat Diagn

journal_title

Prenatal diagnosis

authors

Sananès N,Gabriele V,Weingertner AS,Ruano R,Sanz-Cortes M,Gaudineau A,Langer B,Nisand I,Akladios CY,Favre R

doi

10.1002/pd.4950

subject

Has Abstract

pub_date

2016-12-01 00:00:00

pages

1139-1145

issue

12

eissn

0197-3851

issn

1097-0223

journal_volume

36

pub_type

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