Long-term neurodevelopmental outcome after intrauterine laser treatment for severe twin-twin transfusion syndrome.
OBJECTIVE
The purpose of this study was to investigate long-term neurodevelopmental outcome after intrauterine laser treatment for twin-twin transfusion syndrome.


METHODS
All 89 surviving infants who were treated between January 1995 and May 1997 were investigated in a single center. Seventy-five children were tested with the Griffiths' Developmental Test Scales at a median age of 21 months; 14 children (median age, 34 months) were tested with the Snijders-Oomen-Non-Verbal-Intelligence Test. All children underwent a detailed standardized physical and neurologic examination.


RESULTS
Sixty-nine infants (78%) showed a normal development (group I), 10 infants (11%) had minor neurologic deficiencies (group II), and 10 infants (11%) had major neurologic deficiencies (group III). No difference between recipient and donor status was observed (P =.93). There was a trend toward a more favorable outcome for those infants who were born as twins (53 infants [81%] in group I and 5 infants [8%] in group III) compared with singleton survivors after intrauterine death of the cotwin (16 infants [67%] in group I and 5 infants [21%] in group III); however, the difference was not significant (P =.12).


CONCLUSIONS
After intrauterine laser treatment for twin-twin transfusion syndrome, 78% of the children had a normal neurodevelopmental status, 11% of the children had minor neurologic deficiencies, and 11% of the children had major neurologic deficiencies, at a median age of 22 months.
Banek
Corinna S
CS
Department of Neonatology, University Children's Hospital, Bonn, Germany.
Hecher
Kurt
K
Hackeloer
Bernhard J
BJ
Bartmann
Peter
P
D002657:Child Development; D002675:Child, Preschool; D005260:Female; D005313:Fetal Death / Q000150:complications; D005330:Fetofetal Transfusion / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007223:Infant; D017075:Laser Coagulation; D008137:Longitudinal Studies; D009420:Nervous System / Q000254:growth & development*; D009422:Nervous System Diseases / Q000209:etiology* / Q000503:physiopathology; D011247:Pregnancy; D012720:Severity of Illness Index