(484) Beneficial Long-Term Neurodevelopmental Effect of Nifedipine in Twin-to-Twin Transfusion Syndrome (TTTS) Management

Retrospective study of all TTTS patients treated by SFLP and nifedipine between 2012 and 2019 with collected ASQ scores prospectively. We excluded cases of death of one or both twins. ASQ examines five developmental domains: communication, gross motor, fine motor, personal-social, and problem solving and is completed by caregivers and then scored. This was compared to a Danish cohort of similar TTTS patients treated by SFLP between 2004 and 2015.

Results:

30 patients met inclusion criteria. The gestational age at SFLP was comparable to the control (20.4 vs. 19.8 weeks). Despite earlier gestational age at delivery (32.6 vs 34.0 weeks), TTTS patients s/p SFLP and treated with nifedipine had demonstrated higher ASQ scores in the categories of communication, gross motor, fine motor, and problem solving (Table 1 and 2 attached).

Conclusion: This is the first study that addresses the impact of medical management on neurodevelopment outcome in TTTS s/p SFLP. Though survival rates are much improved after SFLP in TTTS, neurodevelopmental outcome especially long-term can be further optimized. Nifedipine may be an important adjunctive medication to improve fetal neurodevelopment in that population. Further studies are needed.