Long-term neurodevelopmental outcome in twin-to-twin transfusion syndrome treated with fetoscopic laser surgery.
OBJECTIVE
This study was undertaken to determine the long-term neurodevelopmental outcome in twin-to-twin transfusion syndrome treated with laser.


METHODS
All twin-to-twin transfusion syndrome cases treated at our center with laser between August 2000 and December 2003 were included in the study. Neurologic, mental, and psychomotor development at 2 years of age corrected for prematurity was assessed in all twin-to-twin transfusion syndrome survivors. Neurodevelopmental impairment was defined as any of the following: cerebral palsy, deafness, blindness, mental, or psychomotor development index of the Bayley Scales of Infant Development II less than 2 SD.


RESULTS
A total of 82 twin-to-twin transfusion syndrome pregnancies were treated with fetoscopic laser surgery during the study period. Perinatal survival was 70% (115/164). The incidence of neurodevelopmental impairment was 17% (19/115) and was due to cerebral palsy (n = 8), mental developmental delay (n = 9), psychomotor developmental delay (n = 12), and deafness (n = 1).


CONCLUSIONS
The incidence of neurodevelopmental impairment in twin-to-twin transfusion syndrome survivors treated with laser is high and warrants long-term follow-up.
Lopriore
Enrico
E
Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
Middeldorp
Johanna M
JM
Sueters
Marieke
M
Oepkes
Dick
D
Vandenbussche
Frank P H A
FP
Walther
Frans J
FJ
D002675:Child, Preschool; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005330:Fetofetal Transfusion / Q000601:surgery*; D005332:Fetoscopy / Q000009:adverse effects*; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D011596:Psychomotor Disorders / Q000453:epidemiology / Q000209:etiology*; D013997:Time Factors