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  • Title: Improvement in neurodevelopmental outcome in survivors of twin-twin transfusion syndrome treated with laser surgery.
    Author: van Klink JM, Koopman HM, van Zwet EW, Middeldorp JM, Walther FJ, Oepkes D, Lopriore E.
    Journal: Am J Obstet Gynecol; 2014 Jun; 210(6):540.e1-7. PubMed ID: 24412743.
    Abstract:
    OBJECTIVE: To compare the incidence of neurodevelopmental impairment in surviving children from pregnancies with twin-twin transfusion syndrome (TTTS) treated with laser surgery between 2 time periods. STUDY DESIGN: We compared the neurodevelopmental outcome between the first consecutive cohort of TTTS pregnancies treated with laser surgery from 2000 to 2005, with a cohort treated between 2008 and 2010. Neurologic, cognitive, and motor development was evaluated using Bayley scales at 2 years of age corrected for prematurity. RESULTS: A total of 229 twin pregnancies were treated with laser surgery, 113 in the first cohort and 106 in the recent cohort. Overall survival increased from 70% (158/226) to 80% (170/212) (P = .014). The incidence of neurodevelopmental impairment decreased from 18% (28/152) to 6% (10/155) (P < .01). In multivariate analysis, severe cerebral injury at birth was independently associated with neurodevelopmental impairment (odds ratio, 34.86; 95% confidence interval, 11.83-102.75; P < .01). CONCLUSION: Overall survival in TTTS has improved over time, with a concomitant reduction in the incidence of neurodevelopmental impairment. Research focused on prevention of cerebral injury is needed to further improve outcomes of these complicated twin pregnancies.
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