Multicystic encephalomalacia in liveborn twin with a stillborn macerated co-twin

Yoshioka, Hiroshi; Kadomoto, Yoko; Mino, Masahiro; Morikawa, Yuji; Kasubuchi, Yasuo; Kusunoki, Tomoichi

doi:10.1016/s0022-3476(79)80739-8

Cited by 110 publications

(28 citation statements)

References 10 publications

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“…Occlusions of large arteries as described by Yoshioka et al [60] on angiographies may occur, and regions supplied by the vertebral arteries tend to be spared in most cases.…”

Section: Lesions Related To Fetai Conditions Twinningmentioning

confidence: 88%

“…4) and US the brain lesions can now be detected in vivo. Yoshioka et al [60] and Choulot et al [12] were the first to describe brain anoma lies on CT scan and to stress, already in the title of their paper, the relationship between the lesions and multiple pregnancy. Others [15,33,49,53] described on CT scan or on US multicystic encephalopathy or hydranencephaly in 1 of the twins without much com ment.…”

Section: Lesions Related To Fetai Conditions Twinningmentioning

confidence: 99%

“…A wide range of psychoneuromotor handicaps develops [12,20,34,60], depend ing on the extent of the lesions and on their localization. Microencephaly is the rule al though exceptionally, head circumference may be normal or increased because of hy pertension; CSF is usually clear and colorless with high protein content.…”

Section: ¿ F and R O Fmentioning

confidence: 99%

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Fetal Encephalopathies of Circulatory Origin

Larroche¹

1986

Neonatology

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Fetal brain damage may be due to a variety of pathological conditions resulting in circulatory impairments. With generalized ultrasonography of the fetus, the lesions can be detected in utero and subsequent neurological handicaps of the infants will no longer be attributed to difficult labor and birth. The type of the lesions may be anoxic-ischemic and/or hemorrhagic. The morphological appearance depends on the time of occurrence of the insult in utero and on the time elapsed between the insult and the examination of the brain. Although the pathogenesis of the lesions is not fully understood, they may be related either to maternal, fetal, or placental pathological situations. In a last group of cases no causes as yet have been found.

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“…Occlusions of large arteries as described by Yoshioka et al [60] on angiographies may occur, and regions supplied by the vertebral arteries tend to be spared in most cases.…”

Section: Lesions Related To Fetai Conditions Twinningmentioning

confidence: 88%

Section: Lesions Related To Fetai Conditions Twinningmentioning

confidence: 99%

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Fetal Encephalopathies of Circulatory Origin

Larroche¹

1986

Neonatology

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“…Structural and anatomical defects have been described in children whose monozygotic cotwins died antenatally [15]. Multicystic encephalomalacia has been reported in a live born twin after intrauterine death of the co twin [16]. It has been proposed that emboli zation of thromboplastin-rich material via placental anastomoses in such cases is re sponsible for the central nervous system pa thology [17], Although the neonatal cranial sonogram performed in our case showed subependymal intraventricular hemorrhage, this is very common among very low birth weight infants and is unlikely to be related to the procedures described.…”

Section: Discussionmentioning

confidence: 99%

Early Third Trimester Selective Feticide of a Compromising Twin

Still

Kolatat²,

Corbett³

et al. 1989

Fetal Diagn Ther

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“…Controversy exists about the severity of maternal risk for infection, hemorrhage, and coagulopathy [1][2][3][4]. The surviving cotwin would seem to be in great jeopardy for vascular disruption anomalies due to arteriovenous or venous-venous communications, thromboembolic events, death, or neurologic compromise [5][6][7][8][9]. Fetal death of 1 twin or delayed interval delivery for previable multiple gestations [10] presents a significant dilemma to the clinician with regard to pregnancy management.…”

Section: Introductionmentioning

confidence: 99%

Natural History of Twin Gestation Complicated by in utero Fetal Demise: Associations of Chorionicity, Prematurity, and Maternal Morbidity

et al. 2003

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Objectives: To evaluate the pathophysiology by which the in utero death of 1 twin might increase morbidity to its co-twin survivor and its mother. To assess previously reported risks for maternal disseminated intravascular coagulopathy, peripartal hemorrhage, retained placenta and infection, as well as the fetal risk of prematurity. Material and Methods: A retrospective analysis of the natural history of twin pregnancies from three institutions was performed. A total of 1,989 cases of twin pregnancy were identified, Wayne State University included 1,266 cases from 1984 to 1993; Madigan Army Medical Center 136 cases, 1995–2000, and Rockford Regional Perinatal Center, 587 cases, 1990–2000. The findings were classified by the presence or absence of fetal death in utero (IUFD) as follows: both IUFD (0/0); 1 IUFD (0/+), and both live born (+/+). A case-control study was performed on the subgroup of patients for whom complete records as to chorionicity, etc., were available. Results: Of the 1,989 cases reviewed there were 49 both IUFD (0/0), 61 complicated by 1 IUFD (0/+), and 1,879 with both live born (+/+). The overall fetal death rate for this twin cohort was 55/1,000. IUFD of 1 or both twins was related to an increased risk of previable delivery 55% in 0/0, and 28% in 0/+ versus 4% for +/+ with p < 0.001. IUFD also was associated with early preterm delivery (mean gestational age at delivery of 23 (0/0) and 30 (0/+) versus 35 (+/+) weeks). Chorionicity as well as maternal risks were examined in the case-control study (24 (0/0), 43 (0/+), 134 (+/+)) with the following results: monochorionic placentation was more likely in pregnancies complicated by IUFD (54% (0/0), 51% (0/+) versus 14% (+/+); p < 0.001). Retained placenta, requiring dilation and curettage, occurred more frequently when both twins died in utero, but may be related to the earlier gestational age at delivery. Discussion: Independent of retained placenta, there is no difference in the maternal risks for hemorrhage, abruption, coagulopathy or infection between groups. Immaturity at delivery and monochorionicity are more common in pregnancies complicated by fetal demise. Neonatal morbidity and developmental outcome will be the focus of a longitudinal study comparing cotwin survivors to twins matched for chorionicity and gestational age at delivery.

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Multicystic encephalomalacia in liveborn twin with a stillborn macerated co-twin

Cited by 110 publications

References 10 publications

Fetal Encephalopathies of Circulatory Origin

Fetal Encephalopathies of Circulatory Origin

Early Third Trimester Selective Feticide of a Compromising Twin

Natural History of Twin Gestation Complicated by in utero Fetal Demise: Associations of Chorionicity, Prematurity, and Maternal Morbidity

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