title: Short- and long-term outcome in stage 1 twin-to-twin transfusion syndrome treated with laser surgery compared with conservative management.
abstract: OBJECTIVE
  We sought to compare short- and long-term outcome in Quintero stage 1 twin-to-twin transfusion syndrome (TTTS), managed with laser surgery or conservatively.
  
  
  METHODS
  We conducted a retrospective study of all monochorionic twin pregnancies with stage 1 TTTS referred to our center. Primary outcomes were perinatal survival, neonatal morbidity, and long-term neurodevelopmental outcome.
  
  
  RESULTS
  Fifty women presented with stage 1 TTTS of which 40% (20/50) was treated with laser and 60% (30/50) was managed conservatively. Perinatal survival of both or at least 1 twin was 65% (13/20) and 85% (17/20) in the laser group, and 77% (23/30) and 97% (29/30) in the conservatively managed group (P = .52 and P = .29), respectively. Long-term neurodevelopmental impairment of the surviving infants was found in 0% (0/21) vs 23% (7/30), respectively (P = .03).
  
  
  CONCLUSIONS
  In this retrospective study, long-term outcome in stage 1 TTTS was better after laser surgery than with conservative management, suggesting the need for a randomized controlled trial.
authors.affiliation: Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Marise M
authors.initials: MM
authors.lastname: Wagner
authors.forename: Enrico
authors.initials: E
authors.lastname: Lopriore
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Klumper
authors.forename: Dick
authors.initials: D
authors.lastname: Oepkes
authors.forename: Frank P H A
authors.initials: FP
authors.lastname: Vandenbussche
authors.forename: Johanna M
authors.initials: JM
authors.lastname: Middeldorp
mesh_terms: D000328:Adult; D002547:Cerebral Palsy / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005330:Fetofetal Transfusion / Q000145:classification / Q000401:mortality / Q000601:surgery*; D005332:Fetoscopy; D006801:Humans; D007231:Infant, Newborn; D017075:Laser Coagulation / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D012189:Retrospective Studies