Perioperative fetal hemodynamic changes in twin‐twin transfusion syndrome and neurodevelopmental outcome at two years of age

Gijtenbeek, Manon; Haak, Monique C.; Huberts, Tom J. P.; Middeldorp, Johanna M.; Klumper, Frans; Slaghekke, Femke; Lopriore, Enrico; Oepkes, Dick; Klink, Jeanine M.M. van

doi:10.1002/pd.5690

Cited by 10 publications

(26 citation statements)

References 32 publications

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“…Study or subgroup Lopriore (2009) 11 Sananès (2016) 10 McIntosh (2014) 8 Gray (2011) 12 Gijtenbeek (2020) 14 Total (95% CI) 11 Sananès (2016) 10 Korsakissok (2018) 22 Tosello (2014) 9 Graeve (2012) 13 Gray (2011) 12 Gijtenbeek (2020) 14 Total (95% CI)…”

Section: Leave-one-out Analysismentioning

confidence: 99%

“…Heterogeneity: tau 2 = 0.00; chi 2 = 0.94, df = 7 (P = 1.00); I 2 = 0% 11 Sananès (2016) 10 Korsakissok (2018) 22 Tosello (2014) 9 Graeve (2012) 13 Gray (2011) 12 Matsushima (2020) 23 Gijtenbeek (2020) 14 32 weeks. The pooled mean differences of GA at the time of FLP, GA at delivery and birth weight did not change when each study was excluded.…”

Section: Leave-one-out Analysismentioning

confidence: 99%

“…Preterm birth and very or extremely low birth weight have been well-studied and shown to be associated with major long-term neurodevelopmental adverse outcomes, including cerebral palsy, intellectual disability and sensory impairment 29,30 . For instance, a population-based cohort of 1473 singleton and multiple gestations showed that higher GA at birth (> 27 weeks), compared with GA at birth of 23-26 weeks, was associated significantly with 11 Sananès (2016) 10 McIntosh (2014) 8 Gray (2011) 12 Gijtenbeek (2020) 14 Total (95% CI) 11 Sananès (2016) 10 McIntosh (2014) 8 Gray (2011) 12 Gijtenbeek (2020) 14 Total (95% CI) 134 1139 100.0% Heterogeneity: tau 2 McIntosh (2014) 8 Gray (2011) 12 Gijtenbeek (2020) Graeve (2012) 13 Korsakissok (2018) 22 Sananès (2016) 10 Sananès (2016) 10 a lower risk for NDI (OR, 0.50 (95% CI, 0.37-0.68)) at 2-3-year follow-up 31 .…”

Section: Interpretation Of Findingsmentioning

confidence: 99%

“…All included studies were published between 2009 and 2020. Three studies were conducted in France 9,10,22 , two in The Netherlands 11,14 , two in Australia 8,12 , one in Japan 23 and one in Germany 13 . Three studies were prospective 10,12,22 , five studies were retrospective 8,9,11,14,23 and the design of one study was not reported 13 .…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The incidence of neurodevelopmental impairment (NDI) in TTTS survivors treated with FLP has been shown to be around 4-18% in different cohort studies [4][5][6][7][8][9][10][11][12][13][14] . Prenatal risk factors associated with NDI in TTTS survivors have not been investigated extensively, although several studies concluded that the risk of NDI is comparable between donor and recipient twins 5,15 .…”

Section: Introductionmentioning

confidence: 99%

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Perinatal risk factors of neurodevelopmental impairment after fetoscopic laser photocoagulation for twin–twin transfusion syndrome: systematic review and meta‐analysis

Hessami

Nassr

Sananès

et al. 2021

Ultrasound in Obstet & Gyne

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What are the novel findings of this work? Among fetuses with twin-twin transfusion syndrome (TTTS) treated with fetoscopic laser photocoagulation, those with later gestational age (GA) at the time of laser surgery, earlier GA at delivery and lower birth weight were found to be at increased risk of developing neurodevelopmental impairment (NDI) in early childhood. However, no significant association was found between Quintero stage of TTTS and risk of NDI. What are the clinical implications of this work?Clarification of the perinatal risk factors of NDI can be useful in clinical practice for parental counseling and identification of TTTS survivors at risk of developing NDI in future life.

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Section: Leave-one-out Analysismentioning

confidence: 99%

Section: Leave-one-out Analysismentioning

confidence: 99%

Section: Interpretation Of Findingsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Perinatal risk factors of neurodevelopmental impairment after fetoscopic laser photocoagulation for twin–twin transfusion syndrome: systematic review and meta‐analysis

Hessami

Nassr

Sananès

et al. 2021

Ultrasound in Obstet & Gyne

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Fetal and neonatal brain lesions following laser ablation for twin‐to‐twin‐transfusion‐syndrome as detected by pre‐ and post‐natal brain imaging

et al. 2021

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Objective To determine the rate of and risk factors for fetal and neonatal brain lesions following laser ablation for twin‐to‐twin transfusion syndrome (TTTS). Methods A retrospective cohort study of 83 women with monochorionic twin pregnancies who underwent ablation for TTTS at a single tertiary hospital. Post‐laser survivors were followed‐up with fetal neurosonogram every 2 weeks and fetal brain MRI at 28–32 weeks of gestation; post‐natal brain imaging included neurosonogram. Cases with pre‐ and post‐natal brain lesions were compared to those without. Results 153 fetuses survived the immediate post‐laser period and underwent brain imaging. Of these, 17 (11.11%) exhibited brain lesions on prenatal imaging studies, and 36 (32.4%) on post‐natal ultrasound. Later gestational age (GA) at the time of ablation (23.0 vs. 21.4 weeks, p = 0.0244), post‐laser twin‐anemia‐polycythemia‐sequence (TAPS) (29.41% vs. 9.56%, p = 0.035) and birthweight discordancy (30% vs. 9%, p = 0.0025) were associated with prenatal brain lesions. Earlier GA at delivery (31.0 weeks vs. 32.2, p = 0.0002) and post‐laser TAPS (25% vs. 9.33%, p = 0.038) were associated with post‐natal brain lesions. Conclusions Survivors of ablation for TTTS are at risk for brain lesions, which can be detected prenatally. Incorporation of neurosonogram and fetal brain MRI into the routine surveillance of such pregnancies should be considered.

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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

et al. 2022

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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. Key points What's already known about this topic?� The rate of neurodevelopmental impairment among monochorionic (MC) twins is higher than in dichorionic twins and singletons � Limited data suggest that neurodevelopmental outcome of fetuses with selective fetal growth restriction is worse than that of the normally growing co-twin.

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Perioperative fetal hemodynamic changes in twin‐twin transfusion syndrome and neurodevelopmental outcome at two years of age

Cited by 10 publications

References 32 publications

Perinatal risk factors of neurodevelopmental impairment after fetoscopic laser photocoagulation for twin–twin transfusion syndrome: systematic review and meta‐analysis

Perinatal risk factors of neurodevelopmental impairment after fetoscopic laser photocoagulation for twin–twin transfusion syndrome: systematic review and meta‐analysis

Fetal and neonatal brain lesions following laser ablation for twin‐to‐twin‐transfusion‐syndrome as detected by pre‐ and post‐natal brain imaging

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

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