Document Detail

Prevalence and risk factors of cerebral lesions in neonates after laser surgery for twin-twin transfusion syndrome.
MedLine Citation:
PMID:  23021698     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To identify risk factors for cerebral lesions among survivors of twin-twin transfusion syndrome treated with laser surgery.
STUDY DESIGN: A multilevel regression analysis examined risk factors for neonatal cerebral lesions identified by imaging. Imaging was routine in "high-risk survivors," defined as those delivered at <32 weeks' gestation, and by clinical indications if born later. Severe lesions were defined as: intraventricular hemorrhage grade III-IV, cystic periventricular leukomalacia, ventriculomegaly and/or hydrocephalus, microcephaly, infarctions, porencephalic/Dandy-Walker cysts, or bilateral other cysts.
RESULTS: For 262 consecutive laser-treated twin-twin transfusion syndrome patients, 18 neonates had severe lesions identified among 427 individual survivors (4.2%) and 242 "high-risk survivors" (7.4%). Forty-six newborns had any cerebral lesion, resulting in lesion rates of 10.8%-19.0%. Delivery <32 weeks' (odds ratio, 4.95; P < .001) and <28 weeks' (odds ratio, 6.25; P < .001) gestation were associated with increased likelihood of any cerebral lesion.
CONCLUSION: This cohort showed low rates (4-7%) of severe neonatal cerebral lesions, with prematurity being the primary risk factor.
Douglas L Vanderbilt; Sheree M Schrager; Arlyn Llanes; Ramen H Chmait
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  207     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-01     Completed Date:  2012-12-13     Revised Date:  2013-10-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  320.e1-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
Division of General Pediatrics, Department of Pediatrics, Keck School of Medicin, University of Southern California, Los Angeles, CA, USA.
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MeSH Terms
Fetofetal Transfusion / surgery*
Fetoscopy / adverse effects
Hydrocephalus / epidemiology,  etiology*
Infant, Newborn
Infant, Premature
Intracranial Hemorrhages / epidemiology,  etiology*
Laser Therapy / adverse effects*
Leukomalacia, Periventricular / epidemiology,  etiology*
Risk Factors
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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