Long-term neurodevelopmental outcome in twin-to-twin transfusion syndrome treated with fetoscopic laser surgery
Enrico Lopriore1, Johanna M Middeldorp, Marieke Sueters
1Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
Objective:
This study was undertaken to determine the long-term neurodevelopmental outcome in twin-to-twin transfusion syndrome treated with laser.
Study Design:
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).
Conclusion:
The incidence of neurodevelopmental impairment in twin-to-twin transfusion syndrome survivors treated with laser is high and warrants long-term follow-up.
