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Outcome for children born after in utero laser ablation therapy for severe twin-to-twin transfusion syndrome

Sutcliffe, AG; Sebire, NJ; Pigott, AJ; Taylor, B; Edwards, PR; Nicolaides, KH; (2001) Outcome for children born after in utero laser ablation therapy for severe twin-to-twin transfusion syndrome. BRIT J OBSTET GYNAEC , 108 (12) 1246 - 1250.

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Abstract

Objective To examine the postnatal development of a group of children born after in utero laser ablation therapy for severe twin-to-twin transfusion syndrome.Design Retrospective cohort outcome study involving assessment of neurodevelopment and physical well being.Setting Harris Birthright Centre, King's College Hospital, London. Participants Twins and singleton survivors treated via laser ablation therapy for twin-to-twin transfusion syndrome over a four-year period.Methods Of 54 families contacted to participate in the study, who had been treated for twin-to-twin transfusion syndrome during a four-year period, 24 families attended for paediatric assessments 12 pairs of twins and 12 singleton survivors were assessed for perinatal. neurological and neurodevelopmental outcome using the Griffiths scales of mental development, A further 20 families were assessed via a proforma after contact with their general practitioner. A comparison of these groups showed no significant differences in sociodemographic factors or severity of disease between responders (44 families. 81.5%) and non-responders ( 10 families).Results The group of children assessed by a paediatrician had low birthweight (1619g donor. 1814g recipient, 1877g - singleton) and had been born preterm (33 weeks twins, 31.2 weeks singleton) with attendant increased resuscitation, neonatal unit admission (mean 40 days) and instrumental delivery. Mean Griffiths scores were within the normal range of ability (91.2 donor vs 97.7 recipient and 10 1.6 singletons) with the only significant difference being in the locomotor subscale where donor (82.6) and recipient (85.3) were less than singletons: 99.1 (P < 0.05). There was no cerebral palsy in the singleton survivors, but there were five cases in the twin group. All except one affected child (with quadriplegia) had mean Griffiths scores in the normal range. In the GP proforma group there was one case, in a twin. of cerebral palsy.Conclusion The overall cerebral palsy rate was 9%: 0% in the singleton survivors group and 13.3% in the twin survivors group. This pilot data highlights the need for careful long term follow up of children affected by twin-to-twin transfusion syndrome.

Type: Article
Title: Outcome for children born after in utero laser ablation therapy for severe twin-to-twin transfusion syndrome
Keywords: INTRAUTERINE DEATH, PREGNANCIES, AMNIOCENTESIS, MANAGEMENT, SURGERY
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Inst for Women's Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > UCL GOS Institute of Child Health > ICH Pop, Policy and Practice Prog
URI: http://discovery.ucl.ac.uk/id/eprint/85635
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