Long-term neurodevelopmental outcome after intrauterine laser treatment for severe twin-twin transfusion syndrome

Am J Obstet Gynecol. 2003 Apr;188(4):876-80. doi: 10.1067/mob.2003.202.

Abstract

Objective: The purpose of this study was to investigate long-term neurodevelopmental outcome after intrauterine laser treatment for twin-twin transfusion syndrome.

Study design: All 89 surviving infants who were treated between January 1995 and May 1997 were investigated in a single center. Seventy-five children were tested with the Griffiths' Developmental Test Scales at a median age of 21 months; 14 children (median age, 34 months) were tested with the Snijders-Oomen-Non-Verbal-Intelligence Test. All children underwent a detailed standardized physical and neurologic examination.

Results: Sixty-nine infants (78%) showed a normal development (group I), 10 infants (11%) had minor neurologic deficiencies (group II), and 10 infants (11%) had major neurologic deficiencies (group III). No difference between recipient and donor status was observed (P =.93). There was a trend toward a more favorable outcome for those infants who were born as twins (53 infants [81%] in group I and 5 infants [8%] in group III) compared with singleton survivors after intrauterine death of the cotwin (16 infants [67%] in group I and 5 infants [21%] in group III); however, the difference was not significant (P =.12).

Conclusion: After intrauterine laser treatment for twin-twin transfusion syndrome, 78% of the children had a normal neurodevelopmental status, 11% of the children had minor neurologic deficiencies, and 11% of the children had major neurologic deficiencies, at a median age of 22 months.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child Development*
  • Child, Preschool
  • Female
  • Fetal Death / complications
  • Fetofetal Transfusion / complications*
  • Fetofetal Transfusion / surgery*
  • Humans
  • Infant
  • Laser Coagulation*
  • Longitudinal Studies
  • Nervous System / growth & development*
  • Nervous System Diseases / etiology*
  • Nervous System Diseases / physiopathology
  • Pregnancy
  • Severity of Illness Index