Abstract
Objective:
The main objective of this study was to review the available scientific evidence about mid-term neurological outcomes in twins after laser therapy for twin-to-twin transfusion syndrome (TTTS).
Methods:
A systematic review of studies on neurodevelopmental outcomes (cognition, motor development, communication skills and cerebral palsy) of twins after laser therapy for TTTS was conducted. Outcomes at 24 months of age and the use of validated scales for assessment were the selected criteria. Electronic and manual research identified 25 studies, and nine of them were eligible for the review.
Results:
The global mean rate of neurological injury in twins treated with laser was 14.07%. The mean rate of cognitive impairment was 8.41%, 11.14% for motor delay, 16.5% for communication delay and 5.73% for cerebral palsy. These rates were higher than the results found in dichorionic twins, but lower than the results found in twins treated with amnio-reductions or conservative management.
Conclusion:
Laser therapy is associated with a lower rate of neurological injury at 24 months of age compared to other therapeutic techniques. This tendency was also observed with specific incidences regarding cognition, motor skills and cerebral palsy.
Authors’ statement
Conflict of interest: Authors state no conflict of interest.
Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.
Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.
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©2018 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorial
- Fetal anomalies – From prenatal diagnosis to therapy
- Corner of Academy
- The first trimester aneuploidy biochemical markers in IVF/ICSI patients have no additional benefit compared to spontaneous conceptions in the prediction of pregnancy complications
- Research articles – Obstetrics
- Assessment of strain and dyssynchrony in normal fetuses using speckle tracking echocardiography – comparison of three different ultrasound probes
- Inborn errors of metabolism in a cohort of pregnancies with non-immune hydrops fetalis: a single center experience
- Cytogenetic analysis in fetuses with late onset abnormal sonographic findings
- Fetal MRI, lower acceptance by women in research vs. clinical setting
- Neurological complications after therapy for fetal-fetal transfusion syndrome: a systematic review of the outcomes at 24 months
- Evaluation of management and surgical outcomes in pregnancies complicated by acute cholecystitis
- Pentaerythrityltetranitrate (PETN) improves utero- and feto-placental Doppler parameters in pregnancies with impaired utero-placental perfusion in mid-gestation – a secondary analysis of the PETN-pilot trial
- Early onset preeclampsia is associated with an elevated mean platelet volume (MPV) and a greater rise in MPV from time of booking compared with pregnant controls: results of the CAPE study
- Effect of maternal age, height, BMI and ethnicity on birth weight: an Italian multicenter study
- Risk factors and classification of stillbirth in a Middle Eastern population: a retrospective study
- Selective IUGR in dichorionic twins: what can Doppler assessment and growth discordancy say about neonatal outcomes?
- Early fetal megacystis: Is it possible to predict the prognosis in the first trimester?
- Research articles – Fetus
- A poor long-term neurological prognosis is associated with abnormal cord insertion in severe growth-restricted fetuses
- Birth-weight centiles and the risk of serious adverse neonatal outcomes at term
- Short communication
- Maternal and neonatal vitamin D deficiency and transient tachypnea of the newborn in full term neonates
- Acknowledgment
Articles in the same Issue
- Frontmatter
- Editorial
- Fetal anomalies – From prenatal diagnosis to therapy
- Corner of Academy
- The first trimester aneuploidy biochemical markers in IVF/ICSI patients have no additional benefit compared to spontaneous conceptions in the prediction of pregnancy complications
- Research articles – Obstetrics
- Assessment of strain and dyssynchrony in normal fetuses using speckle tracking echocardiography – comparison of three different ultrasound probes
- Inborn errors of metabolism in a cohort of pregnancies with non-immune hydrops fetalis: a single center experience
- Cytogenetic analysis in fetuses with late onset abnormal sonographic findings
- Fetal MRI, lower acceptance by women in research vs. clinical setting
- Neurological complications after therapy for fetal-fetal transfusion syndrome: a systematic review of the outcomes at 24 months
- Evaluation of management and surgical outcomes in pregnancies complicated by acute cholecystitis
- Pentaerythrityltetranitrate (PETN) improves utero- and feto-placental Doppler parameters in pregnancies with impaired utero-placental perfusion in mid-gestation – a secondary analysis of the PETN-pilot trial
- Early onset preeclampsia is associated with an elevated mean platelet volume (MPV) and a greater rise in MPV from time of booking compared with pregnant controls: results of the CAPE study
- Effect of maternal age, height, BMI and ethnicity on birth weight: an Italian multicenter study
- Risk factors and classification of stillbirth in a Middle Eastern population: a retrospective study
- Selective IUGR in dichorionic twins: what can Doppler assessment and growth discordancy say about neonatal outcomes?
- Early fetal megacystis: Is it possible to predict the prognosis in the first trimester?
- Research articles – Fetus
- A poor long-term neurological prognosis is associated with abnormal cord insertion in severe growth-restricted fetuses
- Birth-weight centiles and the risk of serious adverse neonatal outcomes at term
- Short communication
- Maternal and neonatal vitamin D deficiency and transient tachypnea of the newborn in full term neonates
- Acknowledgment