Cerebral Injury and Neurodevelopmental Outcome in Twin-Twin Transfusion Syndrome

Twin-twin transfusion syndrome (TTTS) is a severe complication of monochorionic twin pregnancies associated with high perinatal mortality and morbidity rates. Management in TTTS is a major challenge for obstetricians and neonatologists. Twins with TTTS often are born prematurely after an extremely distressing and highly hazardous fetal period. In addition to complications associated with prematurity, surviving twins with TTTS are at increased risk for other complications, including neurological, cardiovascular, renal, and hematologic morbidity. Follow-up studies report varying rates of cerebral palsy and long-term neurodevelopmental impairment. This review focuses on the cerebral injury during the neonatal period as well as long-term neurodevelopmental outcome of TTTS survivors.