Lopriore Enrico, Middeldorp Johanna M, Sueters Marieke, Oepkes Dick, Vandenbussche Frank P H A, Walther Frans J
Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
Am J Obstet Gynecol. 2007 Mar;196(3):231.e1-4. doi: 10.1016/j.ajog.2006.10.906.
This study was undertaken to determine the long-term neurodevelopmental outcome in twin-to-twin transfusion syndrome treated with laser.
All twin-to-twin transfusion syndrome cases treated at our center with laser between August 2000 and December 2003 were included in the study. Neurologic, mental, and psychomotor development at 2 years of age corrected for prematurity was assessed in all twin-to-twin transfusion syndrome survivors. Neurodevelopmental impairment was defined as any of the following: cerebral palsy, deafness, blindness, mental, or psychomotor development index of the Bayley Scales of Infant Development II less than 2 SD.
A total of 82 twin-to-twin transfusion syndrome pregnancies were treated with fetoscopic laser surgery during the study period. Perinatal survival was 70% (115/164). The incidence of neurodevelopmental impairment was 17% (19/115) and was due to cerebral palsy (n = 8), mental developmental delay (n = 9), psychomotor developmental delay (n = 12), and deafness (n = 1).
The incidence of neurodevelopmental impairment in twin-to-twin transfusion syndrome survivors treated with laser is high and warrants long-term follow-up.
本研究旨在确定接受激光治疗的双胎输血综合征的长期神经发育结局。
本研究纳入了2000年8月至2003年12月在我们中心接受激光治疗的所有双胎输血综合征病例。对所有双胎输血综合征幸存者在矫正早产的2岁时的神经、智力和精神运动发育进行了评估。神经发育障碍定义为以下任何一种情况：脑性瘫痪、耳聋、失明、贝利婴儿发育量表第二版的智力或精神运动发育指数低于2个标准差。
在研究期间，共有82例双胎输血综合征妊娠接受了胎儿镜激光手术治疗。围产期存活率为70%（115/164）。神经发育障碍的发生率为17%（19/115），原因包括脑性瘫痪（n = 8）、智力发育迟缓（n = 9）、精神运动发育迟缓（n = 12）和耳聋（n = 1）。
接受激光治疗的双胎输血综合征幸存者中神经发育障碍的发生率较高，需要进行长期随访。
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