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The surviving monozygotic twin.

W Szymonowicz, H Preston, V Y Yu

    Archives of Disease in Childhood
    |May 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    Vascular disruptions in surviving twins from a deceased co-twin can cause central nervous system and organ infarcts. Prompt delivery and investigation are recommended for suspected monozygous twin pregnancies with fetal death.

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    Area of Science:

    • Perinatology
    • Neurology
    • Pathology

    Background:

    • Monozygous twins share vascular systems, allowing potential transfer of thrombotic material.
    • Disseminated intravascular coagulation (DIC) in a deceased co-twin may lead to embolization in the survivor.

    Observation:

    • Six cases of surviving monozygous twins with central nervous system (CNS) infarcts were identified.
    • Three survivors also presented with previously unreported pulmonary and hepatic infarcts.
    • Fetal death occurred 1-11 weeks prior to the survivor's live birth, with evidence of ongoing infarct processes.

    Findings:

    • All surviving monozygous twins exhibited CNS infarcts.
    • Multiple organ infarcts, including pulmonary and hepatic, were observed in some survivors.

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  • High risk of vascular disruption across multiple organ systems and a poor prognosis for survivors.

    • Implications:

    • Early detection of fetal death in monozygous twins warrants prompt delivery of the survivor.
    • Investigate survivors for CNS and other organ system infarcts to assess prognosis.
    • Findings highlight the severe risks associated with co-twin demise in utero.