title: Incidence, origin, and character of cerebral injury in twin-to-twin transfusion syndrome treated with fetoscopic laser surgery.
abstract: 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.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands. e.lopriore@lumc.nl
authors.forename: Enrico
authors.initials: E
authors.lastname: Lopriore
authors.forename: Gerda
authors.initials: G
authors.lastname: van Wezel-Meijler
authors.forename: Johanna M
authors.initials: JM
authors.lastname: Middeldorp
authors.forename: Marieke
authors.initials: M
authors.lastname: Sueters
authors.forename: Frank P
authors.initials: FP
authors.lastname: Vandenbussche
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Walther
mesh_terms: 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