Long-term developmental follow-up of infants who participated in a randomized clinical trial of amniocentesis vs laser photocoagulation for the treatment of twin-to-twin transfusion syndrome

Limb Constriction Secondary to Pseudoamniotic Band Syndrome after Selective Fetoscopic Laser Surgery: Report of a Case with a Favorable Outcome

“…SFLP was shown to result in at least one survivor at birth and intact survival at 6 months of age in 76 and 56% of the cases, respectively, as compared with 56 and 51%, respectively, in cases treated by aminodrainage [7]. Salomon et al [8] prospectively studied the neurologic and neurodevelopmental outcomes up to the age of 6 years in infants included in the Eurofoetus trial, and concluded that SFLP therapy is associated with an almost 40% reduction in the risk of fetal death or long-term major neurological impairment and that infants treated in the SLFP group had higher ASQ scores at the age of 5 years (60 months).…”

Altered Fetal Cerebral and Cerebellar Development in Twin-Twin Transfusion Syndrome

“…These shifted growth curves are more likely to reflect abnormal development at the microscopic level rather than simply delayed development, given the abnormal neurodevelopmental outcomes in TTTS. 4,5,9,11 It is not unusual for subtle diffuse structural abnormalities to manifest as neurodevelopmental pathology, such as learning disabilities, attention deficit disorder, and behavioral disorders (autism), in contrast to the apparent neurologic deficits associated mainly with readily recognizable focal lesions (porencephaly, cystic PVL), such as in cerebral palsy. As can be seen in premature birth survivors, these diffuse changes may be rather common and may have significant impact on long-term outcomes for surviving children with TTTS.…”

“…3 This cardiovascular instability may trigger further systemic changes that result in multiple organ injury, including the brain, in both twins in utero during the second and third trimesters. In twins, TTTS is a significant cause of cerebral palsy (motor disability) and cognitive and behavioral disabilities 4,5 and is a major cause of prematurity. [6][7][8] There is a high risk of morbidity (12%-22%) 4,[9][10][11] and perinatal mortality (30%) in survivors even after treatment.…”

Twin–Twin Transfusion Syndrome and Twin Anemia–Polycythemia Sequence in a Monochorionic Triamniotic Pregnancy

“…Laser photocoagulation for TTTS in monochorionic twins has been strongly supported in clinical trials (Roberts et al, 2008;Rossi & D'Addario, 2008;Salomon et al, 2010;Senat et al, 2004). In a recent study of monochorionic twins with TTTS, laser photocoagulation was associated with improved survival and improved neurologic outcome (Ages and Stages Questionnaire) compared with amnioreduction at 6 years of age (Salomon et al, 2010). There have been few studies exploring the role of laser photocoagulation or outcomes following treatment in monochorionic triplet pregnancies with TTTS (Chmait et al, 2009;Diemert et al, 2010;Ishii et al, 2006;Sepulveda et al, 2005;Van Shoubroeck et al, 2004).…”