prognosis and long-term neurodevelopmental outcome in conservatively treated twin-to-twin transfusion syndrome预后和长期神经发育的结果在保守治疗双胞胎输血综合征.pdfVIP

Li et al. BMC Pregnancy and Childbirth 2011, 11:32 /1471-2393/11/32 RESEARCH ARTICLE Open Access Prognosis and long-term neurodevelopmental outcome in conservatively treated twin-to-twin transfusion syndrome 1 2* 2 2 2 4 Xiangqun Li , Seiichi Morokuma , Kotaro Fukushima , Yuka Otera , Yasuo Yumoto , Kiyomi Tsukimori , Masayuki Ochiai3, Toshiro Hara3 and Norio Wake2 Abstract Background: Amnioreduction remains a treatment option for pregnancies with twin-to-twin transfusion syndrome (TTTS) not meeting criteria for laser surgery or those in which it is not feasible. Amnioreduction is a relatively simple treatment which does not require sophisticated technical equipment. Previous reports of conservative management have indicated that major neurodevelopmental impairment occurs in 14.3-26% of survivors. The purpose of this study was to investigate long-term neurodevelopmental outcome in conservatively treated TTTS. Methods: During the nine-year study period from January 1996 to December 2004, all pregnancies with TTTS who were admitted to our center were investigated. TTTS was diagnosed by using standard prenatal ultrasound criteria, and staged according to the criteria of Quintero et al. We reviewed gestational age at diagnosis, gestational age at delivery, the stage of TTTS at diagnosis, and diagnosis to delivery interval. Neonatal cranial ultrasound findings were reviewed and the neurodevelopmental outcomes were evaluated. Results: Twenty-one pregnancies with TTTS were included. Thirteen pregnancies (62%) were treated with serial amnioreduction. The mean gestational age at delivery was 28 weeks (22 - 34 weeks). The perinatal mortality rate was 42.9%. Twenty survivors were followed up until at least 3