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. 2022 Jun 1;22(1):458.
doi: 10.1186/s12884-022-04793-x.

Infantile neurodevelopmental outcome after fetoscopic laser photocoagulation for twin-to-twin transfusion syndrome: the first prospective experience from Iran

Nazila Mesbah  1 , Vajiheh Marsousi  2 , Laleh Eslamian  1 , Hadi Montazerlotfelahi  3 , Alireza A Shamshirsaz  4 , Kamran Hessami  4 , Ashraf Jamal  1 , Maryam Noorzadeh  1 , Mahsa Naemi  1 , Marjan Ghaemi  5
Affiliations

Infantile neurodevelopmental outcome after fetoscopic laser photocoagulation for twin-to-twin transfusion syndrome: the first prospective experience from Iran

Nazila Mesbah et al. BMC Pregnancy Childbirth. .

Abstract

Objective: We sought to evaluate the neurodevelopmental outcomes at 12 months of age among infants with twin-to-twin transfusion syndrome (TTTS) undergoing fetoscopic laser photocoagulation (FLP).

Materials and methods: In this prospective longitudinal study, neurodevelopmental assessment was performed among the infants at the corrected age of 12 months, who were diagnosed with TTTS and treated by FLP. The Ages and Stages Questionnaire (ASQ) was filled out by parents. In the next step in infants with abnormal ASQ, motor and cognitive developments were evaluated by Bayley's infant and toddler development scoring system (Bayley 3-Third edition).

Results: In 39 FLP procedures the rate of live birth of at least one twin was 73.8%. Four neonatal deaths were recorded, three of which were due to prematurity and one was due to heart anomaly. The ASQ was normal in 89.7% (35/39) of the infants (group I), 5.1% (2/39) had minor neurodevelopmental impairment (NDI) (group II), and 5.1% (2/39) had major NDI (group III). The 4 infants with abnormal ASQ had Bayley examination which showed two with mild to moderate cerebral palsy and two had delayed verbal skills and autistic spectrum disorder. No significant difference was noted between survivors with and without NDI with respect to donor or recipient status, birth weight, gestational age at birth, Quintero stage of TTTS. In addition, the relationship between gestational age at the time of undergoing FLC and NDI was not significant.

Conclusion: In our population, minor and major neurodevelopmental impairment were seen in 10.2% of the infants. This information is useful for counseling our couples in this population prior the procedure.

Keywords: Fetoscopic laser photocoagulation; Monochorionic; Neurodevelopment; Twin pregnancy; Twin twin transfusion syndrome.

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Conflict of interest statement

None to disclose.

Figures

Fig. 1
Fig. 1
The diagram recruiting cases of study
Fig. 2
Fig. 2
The justified scores of infants with neurodevelopmental impairment
See this image and copyright information in PMC

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