What are the novel findings of this work?Maternal cardiovascular indices at 19-23 weeks' gestation are affected significantly by maternal demographic characteristics and elements of medical history known to be associated with an increased risk for subsequent development of pre-eclampsia (PE). After adjustment for these maternal factors, only peripheral vascular resistance was affected by PE. What are the clinical implications of this work?Assessment of maternal cardiovascular function provides information on the pathophysiology of PE but is not useful in the prediction of PE.

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Objective: Report survival rates, neonatal mortality and morbidity and long-term outcomes of monochorionic (MC) twin pregnancies complicated by twin-to-twin transfusion syndrome (TTTS) or TTTS plus selective fetal growth restriction (sFGR) treated by endoscopic laser surgery. Methods:Retrospective cohort study including 149 MC twin pregnancies complicated by TTTS or TTTS plus sFGR.Medical records were reviewed for survival rates, neonatal mortality, neonatal morbidity and long-term outcomes at 2 and 6 years of age.Results: Survival of both babies was higher in the TTTS group than in the TTTS plus sFGR group (72.9%vs.54.8%); survival of at least one baby was similar in the two groups (90.7% and 88.1%). The incidence of severe neurological disability was not significantly different between TTTS and TTTS plus fetal growth restriction group at both stages, 1.9% versus 2.3% (p-value = 1) and 3.4%vs6.1% (p-value = 0.31).Multivariable analysis demonstrated that intact neurological outcome at 2 years of age was related with gestational age (GA) at birth and z score birthweight (Z BW), and at 6 years of age with GA at birth, Z BW and TTTS stage4. sFGR or abnormal brain findings at neonatal ultrasound were not related with impaired neurological outcome at two or 6 years of age. Conclusions:In pregnancies with TTTS and TTTS plus sFGR survival of at least one baby and long-term neurological outcome are comparable between both groups. Key points What's already known about this topic?� The rate of neurodevelopmental impairment among monochorionic (MC) twins is higher than in dichorionic twins and singletons � Limited data suggest that neurodevelopmental outcome of fetuses with selective fetal growth restriction is worse than that of the normally growing co-twin.