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

Current Status of Minimal Access Surgery (MAS) in the Field of Maternal-Fetal Medicine

“…mildly delayed motor development) while 11% had major neurological sequel such cerebral palsy. 21 These findings were similar to the one reported in the eurofetus (major abnormalities in 13%). 22 In his study, no difference was noted between the amnioreduction and laser-treated group.…”

Prematurity and twinning

“…NDI, however, is still relatively common and not always well documented in long term follow-up studies. Results from some studies report an incidence of major neurological impairment in infancy up to the fourth year of age ranging from 6 to 9%, with an equal incidence of minor neurologic abnormalities in one report [25]. The largest analysis concerning long-term neurodevelopmental outcome after TTTS with laser surgery was published by Lopriore et al .…”

Altered Fetal Cerebral and Cerebellar Development in Twin-Twin Transfusion Syndrome

“…These shifted growth curves are more likely to reflect abnormal development at the microscopic level rather than simply delayed development, given the abnormal neurodevelopmental outcomes in TTTS. 4,5,9,11 It is not unusual for subtle diffuse structural abnormalities to manifest as neurodevelopmental pathology, such as learning disabilities, attention deficit disorder, and behavioral disorders (autism), in contrast to the apparent neurologic deficits associated mainly with readily recognizable focal lesions (porencephaly, cystic PVL), such as in cerebral palsy. As can be seen in premature birth survivors, these diffuse changes may be rather common and may have significant impact on long-term outcomes for surviving children with TTTS.…”

“…In twins, TTTS is a significant cause of cerebral palsy (motor disability) and cognitive and behavioral disabilities 4,5 and is a major cause of prematurity. [6][7][8] There is a high risk of morbidity (12%-22%) 4,[9][10][11] and perinatal mortality (30%) in survivors even after treatment.…”