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Monday, July 9 • 15:45 - 16:00
Session 1 | Fetal Therapy: 1-4 Preliminary Results of a Long-Term Follow-Up Study in Spontaneous Twin Anemia-Polycythemia Sequence

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Preliminary Results of a Long-Term Follow-Up Study in Spontaneous Twin Anemia-Polycythemia Sequence
Lisanne Tollenaar1, Enrico Lopriore2, Femke Slaghekke1, Annemieke Middeldorp2, Dick Oepkes1, Jeanine Van Klink1

1Leiden University Medical Center, Leiden, Netherlands
2Leiden Universitary Medical Center, Leiden, United States
Objectives
To study the long-term neurodevelopmental outcome in a large cohort of  twins with spontaneous twin anemia-polycythemia sequence (TAPS).
Methods
Neurological, motor and cognitive development will be assessed in a consecutive cohort of spontaneous TAPS survivors born between 2005 and 2016. The primary outcome is severe neurodevelopmental impairment (NDI), a composite outcome including: cerebral palsy, bilateral hearing loss, bilateral blindness and  severe motor and/or cognitive development delay. We will  evaluate the correlation between adverse outcome and potential risk factors, such as type of TAPS management, prematurity and donor versus recipient status.
Results
In total, 37 spontaneous TAPS twins were evaluated at the Leiden University Medical Center. Overall perinatal survival was 88%(65/74). In total, 29 cases were managed expectantly, 4 cases were treated with laser surgery, 3 cases with intrauterine transfusion and in 1 case selective feticide was performed. In total, 65 children were eligible for long-term follow-up. Up to February 2018, we evaluated long-term outcome in 50/65 children. Severe NDI was detected in 3/50(6%) of the TAPS twins. A large difference in mild-to-moderate NDI was seen between donors and recipient: 10/24(42%) and 4/26(15%), respectively. We expect to complete the follow-up in all cases in June 2018.
Conclusions
We will present the first study on  long-term neurodevelopmental outcome in a cohort of spontaneous TAPS twins. Our data can be used to counsel parents and design adequately powered, prospective studies to determine the best management option in spontaneous TAPS.

Speakers
avatar for Lisanne Tollenaar

Lisanne Tollenaar

Department of Obstetrics, Leiden University Medical Centre


Monday July 9, 2018 15:45 - 16:00 CEST
Okapi Room 2&3