Short and medium-term outcomes of live-born twins after fetoscopic laser therapy for twin-twin transfusion syndrome
Résumé
OBJECTIVE: To evaluate short and medium term outcomes of children born of monochorionic pregnancies complicated by twin-twin transfusion syndrome treated by fetoscopic laser surgery. METHODS: This was a retrospective observational study performed between May 2007 and 2012. Neonatal data was from 45 patients under 5 years of age. The prospective observational study was of the neurologic outcome of these children using the Ages and Stages Questionnaire (ASQ), 2nd edition, French version, at up to 5 years of age. RESULTS: Neurologic assessment at discharge from maternity unit was normal for 41 infants (93.2%). Logistic regression suggested that the risk of neurosensory sequelae was significantly related to the status of donor [odds ratio=4.62 (1.18; 18.0)] and significantly preterm birth \textless32 weeks of gestation [odds ratio=5.50 (1.38; 21.9)]. Eleven questionnaires were considered abnormal (31.1%). Two children presented a severe neurologic abnormality (5.7%). There was no significant correlation between any area of the questionnaire and status at birth (donor or recipient). CONCLUSIONS: The data from our cohort, particularly as regards neurologic outcome, were satisfactory and concordant with previously published results. The use of the ASQ as a screening tool for neurologic outcome in children is original, which allowed in our cohort to highlight early neurological disorders.
Mots clés
Adult
Child
Preschool
Developmental Disabilities/diagnosis/*etiology
Female
Fetofetal Transfusion/complications/*surgery
Fetoscopy/*methods
Follow-Up Studies
Humans
Infant
Newborn
Laser Coagulation/*methods
Linear Models
Logistic Models
Male
Multivariate Analysis
Nervous System Diseases/diagnosis/*etiology
Pregnancy
Prospective Studies
Retrospective Studies
Surveys and Questionnaires
Treatment Outcome