Incidence, origin, and character of cerebral injury in twin-to-twin transfusion syndrome treated with fetoscopic laser surgery.
OBJECTIVE
The objective of the study was to determine the incidence, origin, and character of cerebral lesions in monochorionic twins with twin-to-twin transfusion syndrome treated with fetoscopic laser surgery.


METHODS
This was a prospective study of monochorionic twins with twin-to-twin transfusion syndrome treated with fetoscopic laser surgery and monochorionic twins without twin-to-twin transfusion syndrome delivered at our center between June 2002 and September 2005, using cranial ultrasonography.


RESULTS
Incidence of antenatally acquired severe cerebral lesions in the twin-to-twin transfusion syndrome group was 10% (8/84) and 2% (2/108) in the non-twin-to-twin transfusion syndrome group (P = .02). Incidence of severe cerebral lesions at discharge was 14% (12/84) in the twin-to-twin transfusion syndrome group and 6% (6/108) in the non-twin-to-twin transfusion syndrome group (P = .04). Antenatal injury was responsible for severe cerebral lesions in 67% (8/12) of the twin-to-twin transfusion syndrome group.


CONCLUSIONS
Incidence of severe cerebral lesions in twin-to-twin transfusion syndrome treated with fetoscopic laser surgery is high and results mainly from antenatal injury.
Lopriore
Enrico
E
Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands. e.lopriore@lumc.nl
van Wezel-Meijler
Gerda
G
Middeldorp
Johanna M
JM
Sueters
Marieke
M
Vandenbussche
Frank P
FP
Walther
Frans J
FJ
D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D005330:Fetofetal Transfusion / Q000601:surgery*; D005332:Fetoscopy; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D053685:Laser Therapy / Q000009:adverse effects*; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011446:Prospective Studies; D014430:Twins, Monozygotic; D014463:Ultrasonography