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Infantile Neurodevelopmental Outcome After Fetoscopic Laser Photocoagulation for Twin-To-Twin Transfusion Syndrome: The First Prospective Experience From Iran Publisher Pubmed



Mesbah N1 ; Marsousi V1 ; Eslamian L1 ; Montazerlotfelahi H2 ; Shamshirsaz AA3 ; Hessami K3 ; Jamal A1 ; Noorzadeh M1 ; Naemi M1 ; Ghaemi M4
Authors
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Authors Affiliations
  1. 1. Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Pediatrics, Imam Ali Hospital, Alborz University of Medical Sciences, Karaj, Iran
  3. 3. Maternal Fetal Care Center, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
  4. 4. Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran

Source: BMC Pregnancy and Childbirth Published:2022


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. © 2022, The Author(s).