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Related Experiment Videos

Brain damage in monozygous twins.

J C Larroche1, P Droullé, A L Delezoide

  • 1INSERM U29, Hôpital de Port-Royal, Paris, France.

Biology of the Neonate
|January 1, 1990
PubMed
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Monochorionic twins can develop diverse cerebral lesions, often impacting the recipient twin due to complications from the macerated donor twin. Understanding these feto-fetal transfusion complications is crucial for managing twin pregnancies.

Area of Science:

  • Perinatology
  • Fetal Neurology
  • Twin Studies

Background:

  • Monochorionic twins share a placenta, increasing risks of feto-fetal transfusion syndrome and associated complications.
  • Cerebral lesions in surviving twins of a demised co-twin present a significant clinical challenge with unclear pathogenesis.

Purpose of the Study:

  • To report a series of monochorionic twins with various cerebral lesions.
  • To investigate the potential causes and diagnostic methods for cerebral lesions in surviving twins following fetal demise of a co-twin.

Main Methods:

  • Case series analysis of 15 monochorionic twins with cerebral lesions.
  • Fetal ultrasound (US) utilized in 11 cases for diagnosis.
  • Postnatal transfontanellar US and CT scans used for confirmation in live births.

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Main Results:

  • Cerebral lesions were observed in both recipient and donor twins, with hypoxic-ischemic injuries being most common.
  • Fetal US diagnosed intrauterine growth restriction (IUGR), fetal death, and/or brain lesions in 10 of 11 cases.
  • Lesions in recipients may stem from emboli or thromboplastic material from the macerated twin, or hypotension; donor lesions result from hypotension/anemia.

Conclusions:

  • The pathogenesis of cerebral lesions in surviving twins is complex and not fully understood.
  • Current diagnostic imaging can detect anomalies, but predicting lesions post-fetal demise remains challenging.
  • Further research using Doppler and continuous monitoring is needed to understand feto-fetal transfusion dynamics and hemodynamic changes.