title: Fetal brain imaging following laser surgery in twin-to-twin surgery.
abstract: OBJECTIVE
  To describe the incidence and nature of prenatal brain damage following fetoscopic laser selective coagulation (FLSC) of placental vessels for twin-to-twin transfusion syndrome (TTTS).
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  Single center cohort.
  
  
  METHODS
  All consecutive cases referred for TTTS treated by FLSC between 2003 and 2015.
  
  
  METHODS
  After the FLSC, patients were followed weekly by ultrasound. Fetal magnetic resonance imaging (MRI) scans were systematically planned at 30-32 weeks of gestation.
  
  
  METHODS
  Brain damage diagnosed prenatally by ultrasound or MRI.
  
  
  RESULTS
  In total, 1023 cases were reviewed. Brain damage was diagnosed prenatally in 22/1023 (2.1%) cases. Diagnosis was performed by ultrasound prior to MRI in 18 (82%) cases. All lesions were within the spectrum of ischaemic haemorrhagic lesions. Postoperative twin anaemia polycythaemia sequence and recurrence of TTTS were significantly associated with brain damage.
  
  
  CONCLUSIONS
  The incidence of prenatal brain damage is low following FSLC, and is strongly associated with incomplete surgery.
  
  
  CONCLUSIONS
  Following FSLC for TTTS, prenatal brain damage occurs in 2% of cases and is associated with incomplete surgery.
authors.affiliation: Department of Obstetrics and Gynaecology, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.|EA7328, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.|Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.|Centre National de Référence des Grossesses Monochoriales Compliquées, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Stirnemann
authors.affiliation: Department of Obstetrics and Gynaecology, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.|EA7328, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.|Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.|Centre National de Référence des Grossesses Monochoriales Compliquées, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Chalouhi
authors.affiliation: Department of Obstetrics and Gynaecology, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.|EA7328, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.|Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.|Centre National de Référence des Grossesses Monochoriales Compliquées, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Essaoui
authors.affiliation: Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.|Department of Paediatric Neurology, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.|Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Bahi-Buisson
authors.affiliation: EA7328, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.|Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.|Department of Paediatric Imaging, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Sonigo
authors.affiliation: EA7328, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.|Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.|Department of Paediatric Imaging, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.
authors.forename: A-E
authors.initials: AE
authors.lastname: Millischer
authors.affiliation: EA7328, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.|Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.|Department of Neonatology, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Lapillonne
authors.affiliation: Department of Obstetrics and Gynaecology, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.|Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.|Centre National de Référence des Grossesses Monochoriales Compliquées, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Guigue
authors.affiliation: Department of Obstetrics and Gynaecology, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.|EA7328, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.|Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.|Centre National de Référence des Grossesses Monochoriales Compliquées, Paris, France.
authors.forename: L J
authors.initials: LJ
authors.lastname: Salomon
authors.affiliation: Department of Obstetrics and Gynaecology, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.|EA7328, Université Paris Descartes, Paris Sorbonne-Cité, Paris, France.|Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.|Centre National de Référence des Grossesses Monochoriales Compliquées, Paris, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Ville
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000196:embryology; D005260:Female; D005330:Fetofetal Transfusion / Q000601:surgery*; D005332:Fetoscopy / Q000009:adverse effects* / Q000379:methods; D005333:Fetus / Q000000981:diagnostic imaging / Q000196:embryology; D006801:Humans; D002534:Hypoxia, Brain / Q000000981:diagnostic imaging* / Q000196:embryology / Q000209:etiology; D017075:Laser Coagulation / Q000009:adverse effects* / Q000379:methods; D059906:Neuroimaging / Q000379:methods; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology; D011247:Pregnancy; D049188:Prenatal Injuries / Q000000981:diagnostic imaging* / Q000209:etiology; D012189:Retrospective Studies
keywords: 
  MRI
  ; 
  TAPS
  ; Brain; laser; twin-twin transfusion syndrome