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. 2022 Oct;42(11):1438-1447.
doi: 10.1002/pd.6231. Epub 2022 Sep 8.

Perinatal and long-term outcome of endoscopic laser surgery for twin-twin transfusion syndrome with and without selective fetal growth restriction: A retrospective cohort study

Elena Gibbone  1   2 , Rosa Vallenas Campos  1   2 , Antonio Jérez Calero  3 , Pilar Carretero Lucena  1   4 , Francisca S Molina Garcia  1   4
Affiliations

Perinatal and long-term outcome of endoscopic laser surgery for twin-twin transfusion syndrome with and without selective fetal growth restriction: A retrospective cohort study

Elena Gibbone et al. Prenat Diagn. 2022 Oct.

Abstract

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.

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References

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