OBJECTIVETo explore the clinical manifestations and short-term prognosis of twin-twin transfusion syndrome (TTTS) in neonates with different disease stages, receiving different intrauterine interventions, or as blood donors and recipients.

METHODSThe study retrospectively collected 76 TTTS neonates who were hospitalized in the Neonatal Ward, Peking University Third Hospital. The participants were classified into mild TTTS (n=38) and severe TTTS groups (n=21), or into amnioreduction (n=20), laser surgery (n=21), and expectant therapy groups (n=32), or into donor (n=23) and recipient groups (n=30).

RESULTSThe severe TTTS group had higher incidences of brain injury, heart disease, asphyxia, and renal damage and in-hospital mortality rate compared with the mild TTTS group, but the differences had no statistical significance. The laser surgery group displayed decreasing trends in the incidences of brain injury, heart disease, and renal damage and in-hospital mortality rate compared with the amnioreduction and expectant therapy groups. The recipient group had higher incidences of heart diseases and pathological jaundice than the donor group (P<0.05). The donor group had higher incidences of asphyxia and renal damage than the recipient group, but with no significant difference.

CONCLUSIONSThe neonates with severe TTTS have higher rates of organ damages and in-hospital mortality. Intrauterine laser surgery seems to lead to a better prognosis compared with the amnioreduction and expectant therapy. The recipients are more susceptible to heart diseases and pathological jaundice, whereas the donors are more susceptible to asphyxia and renal damage.