%0 Journal Article %1 Lopriore2003 %A Lopriore, Enrico %A Nagel, Helene T C %A Vandenbussche, Frank P H A %A Walther, Frans J %D 2003 %J Am J Obstet Gynecol %K Brain; Cerebral Palsy; Developmental Disabilities; Diseases in Twins; Female; Fetal Death; Fetofetal Transfusion; Humans; Hypertension; Incidence; Infant Mortality; Infant, Newborn; Mental Retardation; Nervous System Diseases; Pregnancy; Pregnancy Outcome %N 5 %P 1314--1319 %T Long-term neurodevelopmental outcome in twin-to-twin transfusion syndrome. %V 189 %X OBJECTIVE: The purpose of this study was to determine the long-term neurodevelopmental outcome in children after twin-to-twin transfusion syndrome. STUDY DESIGN: Maternal and neonatal medical records of all twin-to-twin transfusion syndrome patients who were admitted to our center between 1990 and 1998 were reviewed. Neurologic and mental development at school age was assessed during a home visit in all twin-to-twin transfusion syndrome survivors. RESULTS: A total of 33 pregnancies with twin-to-twin transfusion syndrome were identified. Four couples opted for termination of pregnancy. All other pregnancies were treated conservatively, 18 pregnancies (62\%) with serial amnioreductions and 11 pregnancies (38\%) without intrauterine interventions. Mean gestational age at delivery was 28.6 weeks (range, 20-37 weeks). The perinatal mortality rate was 50\% (29/58 infants). The birth weight of the donor twins was less than the recipient twins (P<.001). Systolic blood pressure at birth was lower in donors than in recipients (P=.023), and donors required inotropic support postnatally more frequently than did recipients (P=.008). The incidence of hypertension at birth was higher in recipients than in donors (P=.038). Abnormal cranial ultrasonographic findings were reported in 41\% of the neonates (12/29 neonates). All long-term survivors (n=29 neonates) were assessed during a home visit. Mean gestational age at birth of the surviving twin was 31.6 weeks (range, 25-37 weeks). The mean age at follow-up was 6.2 years (range, 4-11 years). The incidence of cerebral palsy was 21\% (6/29 infants). Five of 6 children with cerebral palsy had an abnormal mental development. The incidence of cerebral palsy in the group of survivors who were treated with serial amnioreduction was 26\% (5/19 infants). Four children were born after the intrauterine fetal demise of their co-twin, 2 of which had cerebral palsy. CONCLUSION: The incidence of adverse neurodevelopmental outcome in twin-to-twin transfusion syndrome survivors is high, especially after the intrauterine fetal demise of a co-twin.

@article{Lopriore2003, abstract = {OBJECTIVE: The purpose of this study was to determine the long-term neurodevelopmental outcome in children after twin-to-twin transfusion syndrome. STUDY DESIGN: Maternal and neonatal medical records of all twin-to-twin transfusion syndrome patients who were admitted to our center between 1990 and 1998 were reviewed. Neurologic and mental development at school age was assessed during a home visit in all twin-to-twin transfusion syndrome survivors. RESULTS: A total of 33 pregnancies with twin-to-twin transfusion syndrome were identified. Four couples opted for termination of pregnancy. All other pregnancies were treated conservatively, 18 pregnancies (62\%) with serial amnioreductions and 11 pregnancies (38\%) without intrauterine interventions. Mean gestational age at delivery was 28.6 weeks (range, 20-37 weeks). The perinatal mortality rate was 50\% (29/58 infants). The birth weight of the donor twins was less than the recipient twins (P<.001). Systolic blood pressure at birth was lower in donors than in recipients (P=.023), and donors required inotropic support postnatally more frequently than did recipients (P=.008). The incidence of hypertension at birth was higher in recipients than in donors (P=.038). Abnormal cranial ultrasonographic findings were reported in 41\% of the neonates (12/29 neonates). All long-term survivors (n=29 neonates) were assessed during a home visit. Mean gestational age at birth of the surviving twin was 31.6 weeks (range, 25-37 weeks). The mean age at follow-up was 6.2 years (range, 4-11 years). The incidence of cerebral palsy was 21\% (6/29 infants). Five of 6 children with cerebral palsy had an abnormal mental development. The incidence of cerebral palsy in the group of survivors who were treated with serial amnioreduction was 26\% (5/19 infants). Four children were born after the intrauterine fetal demise of their co-twin, 2 of which had cerebral palsy. CONCLUSION: The incidence of adverse neurodevelopmental outcome in twin-to-twin transfusion syndrome survivors is high, especially after the intrauterine fetal demise of a co-twin.}, added-at = {2014-07-19T20:43:06.000+0200}, author = {Lopriore, Enrico and Nagel, Helene T C and Vandenbussche, Frank P H A and Walther, Frans J}, biburl = {https://www.bibsonomy.org/bibtex/2d43509a918728f166ee035fda15f3993/ar0berts}, groups = {public}, interhash = {4deedf162d6ada86402e1f41379249c6}, intrahash = {d43509a918728f166ee035fda15f3993}, journal = {Am J Obstet Gynecol}, keywords = {Brain; Cerebral Palsy; Developmental Disabilities; Diseases in Twins; Female; Fetal Death; Fetofetal Transfusion; Humans; Hypertension; Incidence; Infant Mortality; Infant, Newborn; Mental Retardation; Nervous System Diseases; Pregnancy; Pregnancy Outcome}, month = Nov, number = 5, pages = {1314--1319}, pii = {S0002937803007609}, pmid = {14634561}, timestamp = {2014-07-19T20:43:06.000+0200}, title = {Long-term neurodevelopmental outcome in twin-to-twin transfusion syndrome.}, username = {ar0berts}, volume = 189, year = 2003 }