Evaluation of long-term neurodevelopment in twin-twin transfusion syndrome after laser therapy.
Prenat Diagn
; 36(12): 1139-1145, 2016 Dec.
Article
in En
| MEDLINE
| ID: mdl-27764900
ABSTRACT
OBJECTIVE:
The primary objective of our study was to evaluate the long-term neurodevelopment outcome after laser surgery for twin-twin transfusion syndrome (TTTS). The secondary objective was to identify perinatal prognostic factors associated with neurodevelopmental impairment.METHOD:
This was a single-center cohort prospective study carried out in pregnancies complicated by TTTS and treated by laser. Neurodevleopmental assesment included the administration of Ages and Stages Questionnaires® (ASQ), for the infants between 2 and 5 years of age.RESULTS:
A total of 187 patients underwent a laser for TTTS between 2004 and 2013. Significant brain lesions were detected in eight (2.9%) cases by ultrasound and/or magnetic resonance imaging including intraventricular hemorrhage, periventricular leukomalacia, and porencephaly. Questionnaires were administered to 126 children (50.4%) at 24 months or older at the moment of testing. There were 13.5% of those infants who had an abnormal ASQ (established as one area or more scoring < 2 SD) at 3.6 years ±1.3 follow-up. There was a higher rate of abnormal ASQ among the infants with a birth weight below the fifth percentile (p = 0.036).CONCLUSION:
Twin-twin transfusion syndrome is associated with a risk of abnormal neurological development, even in case of laser surgery. Further studies are necessary to identify the risk factors for neurological impairment. © 2016 John Wiley & Sons, Ltd.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Leukomalacia, Periventricular
/
Brain
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Cerebral Hemorrhage
/
Fetal Therapies
/
Laser Therapy
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Fetofetal Transfusion
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Porencephaly
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Neurodevelopmental Disorders
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
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Child, preschool
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Female
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Humans
/
Pregnancy
Language:
En
Journal:
Prenat Diagn
Year:
2016
Document type:
Article
Affiliation country:
France