Paper

Long-Term Outcome of Infants with Twin-to-Twin Transfusion Syndrome
Shunji Hikino^a, Shouichi Ohga^a, Takashi Kanda^a, Toshinori Nakashima^a, Junko Yamamoto^a, Hideki Nakayama^a, Hitoo Nakano^b, Toshiro Hara<sup>c

a</sup>Perinatal and Maternity Care Unit, Kyushu University Hospital,
^bDepartment of Obstetrics and Gynecology, and
^cDepartment of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Address of Corresponding Author

Fetal Diagn Ther 2007;22:68-74 (DOI: 10.1159/000095847)

  Key Words

• Twin-to-twin transfusion syndrome (TTTS)
• TTTS infants, long-term outcome
• TTTS, neonatal morbidity and mortality
• TTTS, growth and development
• Monochorionic twins

  Abstract

Objective: To clarify the long-term neurodevelopmental outcome of twin-to-twin transfusion syndrome (TTTS) survivors. Methods: From January 1994 to December 2003, 33 newborns with TTTS who were derived from 18 monochorionic twin gestations were enrolled for the study. The development and growth at 3 or 6 years of age were compared between TTTS survivors and weight-matched singleton controls. Results: The mortality in TTTS (8/33: 24%) was significantly higher than that of the controls (7/80: 9%). Of all 12 TTTS patients who were diagnosed before 25 weeks and born before 28 weeks of gestation, in 10 (83%) it led to neonatal or intrauterine death. The morbidity of cerebral palsy, epilepsy, and mental retardation did not differ between TTTS and control patients. The morbidity and severity of neurological deficits at school age were similar in both groups. No growth parameters at 3 or 6 years of age differed between TTTS and controls. Conclusions: Morbidity, growth and development of TTTS survivors attained comparable levels of weight-matched controls, despite the higher neonatal mortality. These results suggest that the early management of TTTS is critical for refining the total outcome of the affected twins.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Dr. Shunji Hikino
Perinatal and Maternity Care Unit, Kyushu University Hospital
3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan)
Tel. +81 92 642 5421, Fax +81 92 642 5435
E-Mail hikino@pediatr.med.kyushu-u.ac.jp

  Article Information

Received: November 11, 2005
Accepted after revision: April 1, 2006
Published online: September 22, 2006
Number of Print Pages : 7
Number of Figures : 3, Number of Tables : 3, Number of References : 19