Prognosis and long-term neurodevelopmental outcome in conservatively treated twin-to-twin transfusion syndrome

BMC Pregnancy and Childbirth

Research Article

Xiangqun Li¹  Kotaro Fukushima²  Yuka Otera²  Norio Wake²  Yasuo Yumoto²  Seiichi Morokuma²  Toshiro Hara³  Masayuki Ochiai³  Kiyomi Tsukimori⁴ 

[1] Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;Department of Obstetrics and Gynecology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan;Department of Pediatrics, Kyushu University Hospital, Kyushu University, Fukuoka, Japan;Fukuoka Children's Hospital, Fukuoka, Japan;

关键词: fetus;    TTTS;    long-term outcome;   

DOI  :  10.1186/1471-2393-11-32

 received in 2010-08-30, accepted in 2011-04-22,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundAmnioreduction remains a treatment option for pregnancies with twin-to-twin transfusion syndrome (TTTS) not meeting criteria for laser surgery or those in which it is not feasible. Amnioreduction is a relatively simple treatment which does not require sophisticated technical equipment. Previous reports of conservative management have indicated that major neurodevelopmental impairment occurs in 14.3-26% of survivors. The purpose of this study was to investigate long-term neurodevelopmental outcome in conservatively treated TTTS.MethodsDuring the nine-year study period from January 1996 to December 2004, all pregnancies with TTTS who were admitted to our center were investigated. TTTS was diagnosed by using standard prenatal ultrasound criteria, and staged according to the criteria of Quintero et al. We reviewed gestational age at diagnosis, gestational age at delivery, the stage of TTTS at diagnosis, and diagnosis to delivery interval. Neonatal cranial ultrasound findings were reviewed and the neurodevelopmental outcomes were evaluated.ResultsTwenty-one pregnancies with TTTS were included. Thirteen pregnancies (62%) were treated with serial amnioreduction. The mean gestational age at delivery was 28 weeks (22 - 34 weeks). The perinatal mortality rate was 42.9%. Twenty survivors were followed up until at least 3 years of age. The mean age at follow-up was 6.3 years (3 - 12 years). Six children (30%) had neurodevelopmental impairment. Four children (20%) had major neurodevelopmental impairment and two children (10%) had minor neurodevelopmental impairment. Children with neurodevelopmental impairment were delivered before 29 weeks of gestation.ConclusionsOur study showed a high rate of perinatal mortality and a high rate of major neurodevelopmental impairment in conservatively treated TTTS. The long-term outcomes for the survivors with TTTS were good when survivors were delivered after 29 weeks of gestation.

【 授权许可】

Unknown   
© Li et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.