Neurodevelopmental outcome and risk factors for disability for twin-twin transfusion syndrome treated with laser surgery

Am J Obstet Gynecol. 2011 Feb;204(2):159.e1-6. doi: 10.1016/j.ajog.2010.08.041. Epub 2010 Nov 3.

Abstract

Objective: This study was performed to report the neurodevelopmental outcome of survivors of twin-twin transfusion syndrome (TTTS) treated with laser surgery and to determine the risk factors for neurodevelopmental disability.

Study design: A prospective study of TTTS cases treated with laser was performed. Survivors were assessed at 2 years corrected for prematurity. Neurodevelopmental disability was defined as the presence of cerebral palsy, deafness, blindness, or cognitive impairment with a developmental score >2 SDs below the mean.

Results: A total of 75 TTTS pregnancies were treated with a perinatal survival rate of 79.3%. A total of 113 survivors were assessed. The rate of cerebral palsy was 4.4% and cognitive impairment was 8%, with a neurodevelopmental disability rate of 12.4%. Quintero stage was the only independent risk factor for neurodevelopmental disability.

Conclusion: The incidence of neurodevelopmental disability in TTTS survivors treated with laser is considerable, with Quintero stage being an independent risk factor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cerebral Palsy / epidemiology*
  • Cerebral Palsy / etiology
  • Cognition Disorders / epidemiology*
  • Cognition Disorders / etiology
  • Female
  • Fetofetal Transfusion / complications
  • Fetofetal Transfusion / surgery
  • Fetoscopy
  • Humans
  • Incidence
  • Infant, Newborn
  • Laser Therapy
  • Pregnancy
  • Pregnancy Outcome
  • Prospective Studies
  • Risk Factors
  • Treatment Outcome