Twin-twin transfusion syndrome (TTTS) is a serious complication in monochorionic (MC) pregnancies. Fetoscopic laser surgery (FLS) is the primary treatment for advanced TTTS, but managing Quintero stage I TTTS is still controversial. We conducted an observational study evaluating the 2-year neurodevelopment of fetuses, which underwent FLS for stage I TTTS, compared with advanced TTTS and uncomplicated monochorionic diamniotic twins (MCDTs). The study included 156 children: 14 in stage I TTTS group, 28 in advanced TTTS group, and 114 in uncomplicated twin group. In stage I TTTS, 92.9% showed normal neurodevelopment, with no severe neurological impairments observed. These results were comparable with uncomplicated twins (92.1% normal neurodevelopment, P = .921, adjusted odds ratio [aOR] = 1.56, 95% confidence interval [CI] = 0.42-5.79; 1.8% severe impairment, P = .617). Advanced TTTS had a non-significant lower rate of normal neurodevelopment (89.3%, P = .710, aOR = 1.31, 95% CI = 0.12-14.87). In conclusion, FLS for stage I TTTS shows favorable long-term neurodevelopmental outcomes, similar to uncomplicated MC pregnancies.

中文翻译：

---

选择性胎儿镜激光治疗 I 期双胎输血综合征后的长期神经发育结果

双胎输血综合征（TTTS）是单绒毛膜（MC）妊娠的严重并发症。胎儿镜激光手术 (FLS) 是晚期 TTTS 的主要治疗方法，但处理 Quintero I 期 TTTS 仍存在争议。我们进行了一项观察性研究，评估了接受 FLS 进行 I 期 TTTS 的胎儿与晚期 TTTS 和简单的单绒毛膜双羊膜双胞胎 (MCDT) 相比的 2 年神经发育情况。该研究包括 156 名儿童：I 期 TTTS 组 14 名，晚期 TTTS 组 28 名，无并发症双胞胎组 114 名。在 I 期 TTTS 中，92.9% 的人表现出正常的神经发育，没有观察到严重的神经损伤。这些结果与无并发症的双胞胎具有可比性（92.1% 神经发育正常，P = .921，调整优势比 [aOR] = 1.56，95% 置信区间 [CI] = 0.42-5.79；1.8% 严重损伤，P = .617）。高级 TTTS 的正常神经发育率不显着降低（89.3%，P = .710，aOR = 1.31，95% CI = 0.12-14.87）。总之，I 期 TTTS 的 FLS 显示出良好的长期神经发育结果，类似于无并发症的 MC 妊娠。