Twin-to-Twin Transfusion

Abstract

The high morbidity and mortality rates of twin-to-twin transfusion syndrome (TTTS) generally are related to sequelae of cardiovascular dysfunction or vascular disruption. Neurologic sequelae associated with TTTS are emerging concerns for survivors. A variety of clinical interventions, including amnioreduction, microseptostomy of the inter-twin membrane, and fetoscopic laser photocoagulation of placental anastomoses, have been used alone or in sequence to reduce the rates of mortality and morbidity. Because many of these specialized interventional procedures are performed at select centers in the United States, women may be treated at considerable distance from their primary obstetric care institutions and later return to deliver at their local facilities. Neonatologists may be unfamiliar with the relative efficacies and outcomes of the interventional procedures. In this review, we present a focused summary of the neurodevelopmental outcomes associated with these antenatal treatments.