Neurodevelopmental outcome in twin anemia-polycythemia sequence after laser surgery for twin-twin transfusion syndrome.
Ultrasound Obstet Gynecol
; 44(3): 316-21, 2014 Sep.
Article
en En
| MEDLINE
| ID: mdl-24753027
ABSTRACT
OBJECTIVE:
To evaluate the long-term neurodevelopmental outcome in children who developed twin anemia-polycythemia sequence (TAPS) after fetoscopic laser surgery for twin-twin transfusion syndrome (TTTS).METHODS:
Neurological, motor and cognitive development was assessed in a consecutive cohort of TTTS survivors treated with laser surgery between 2004 and 2011 and complicated by post-laser TAPS. Primary outcome was neurodevelopmental impairment, a composite outcome including any of the following cerebral palsy, bilateral deafness, blindness, severe motor and/or cognitive developmental delay (>2 SD below the mean). A risk analysis on cognitive outcome was performed.RESULTS:
During the study period, 33/306 (11%) monochorionic twin pairs developed TAPS after laser surgery for TTTS. Survival was 53/66 (80%). Long-term outcome was assessed in 47/53 (89%) children. The incidence of neurodevelopmental impairment was 4/47 (9%), occurring in one donor (1/20; 5%) and three recipients (3/27; 11%) (P=0.63). Mild-to-moderate cognitive delay, i.e. scores below 85, was detected in 8/47 (17%) children. Risk factors for low cognitive scores were low gestational age at birth (P=0.02) and low birth weight (P<0.01). The lowest cognitive scores were detected in the subgroup of TAPS survivors treated with intrauterine transfusion (median score, 82.5).CONCLUSIONS:
Neurodevelopmental impairment and cognitive delay were found in almost one in five children surviving post-laser TAPS. Better treatment and, ideally, prevention of this complication after laser treatment for TTTS is urgently needed.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Policitemia
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Transfusión de Sangre Intrauterina
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Parálisis Cerebral
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Ceguera
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Sordera
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Terapia por Láser
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Transfusión Feto-Fetal
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Anemia
Tipo de estudio:
Etiology_studies
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Evaluation_studies
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Incidence_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Child, preschool
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Female
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Humans
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Male
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Newborn
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Pregnancy
Idioma:
En
Año:
2014
Tipo del documento:
Article