Sequential Fetus-Fetus Interaction and C.N.S. Defects

Durkin, M.V.; Kaveggia, Elisabeth G.; Pendleton, E.; Opitz, JohnM.

doi:10.1016/s0140-6736(76)92997-4

Cited by 10 publications

(3 citation statements)

References 10 publications

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“…They postulated that such cell rests are more likely to occur after spontaneous abortion than after normal delivery. Further studies confirmed the observation that the prevalence of spontaneous abortions was higher in pregnancies preceding those that result in fetuses with NTD than in pregnancies following them [Field and Kerr, 1976;Durkin et al, 1976;Laurence and Roberts, 1977;David et al, 19801. Other studies showed a higher frequency of abortions in pregnancies immediately prior to the one with an NTD affected fetus than prior to normal newborn infants that served as controls [Smithells et al, 1964;Smithells and Chinn, 1965;Myrianthopou10s and Melnick, 19871.…”

Section: Introductionmentioning

confidence: 61%

Spontaneous abortion–high risk factor for neural tube defects in subsequent pregnancy

et al. 1994

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An increased spontaneous abortion rate has been observed in pregnancies preceding that of fetuses or newborn infants with neural tube defects (NTDs). There are 2 suggested explanations for this observation. One is that a trophoblastic cell rest, remaining from a previous aborted pregnancy, interferes with normal embryogenesis. The second is that the previous lost fetus was affected with NTD. We studied the obstetric history of mothers of newborn infants with NTDs compared to those with other birth defects, in low and high risk groups for NTD (Jew and Bedouins). A significantly higher spontaneous abortion rate (48%) in the preceding pregnancy was found in the NTD group compared to the group with other birth defects (20%). This was especially remarkable for spina bifida cases in the Jewish study population. A significantly higher rate of preceding spontaneous abortion was also found in congenital heart defects (CHD) when compared to other congenital malformations. A hypothesis based on the multifactorial threshold model is put forward to explain these findings. Based on the realization that spontaneous abortion constitutes a high risk factor for NTD and possibly also CHD, we recommend a delay of subsequent pregnancy and periconceptional treatment with folic acid following spontaneous abortion.

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Section: Introductionmentioning

confidence: 61%

Spontaneous abortion–high risk factor for neural tube defects in subsequent pregnancy

et al. 1994

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“…The shorter interval following miscarriage is likely a consequence of greater reproductive drive, rather than a relationship of trophoblastic rests to miscarriage and subsequent NTDs. Laurence and Roberts [1977], Carter et a1 [1975], and Durkin et al [1976] !n nne w n m n cn VI found no decrease in pregnancy interval before an NTD pregnancy compared to intervals noted in control women. The trophoblast rest theory also predicted a greater male excess in sibs born immediately before a female proband than before a male propositus.…”

Section: Reproductive Historymentioning

confidence: 99%

Neural tube defects in Eastern Ontario and Western Quebec: Demography and family data

Hunter

1984

Am. J. Med. Genet.

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This paper reports the results of a study of families in the Eastern Ontario/Western Quebec region who had a child born with a neural tube defect during the years 1969-1981. As in several other geographic areas, the prevalence of neural tube defects at birth has fallen from previous levels. However, there was no evidence of further decline during the period of study. Socioeconomic and ethnic influences were noted, but there was no evidence of seasonal variation or any correlation with maternal age or parity. There was support for a causative role of maternal fever in some cases. The rates of miscarriage varied between pregnancies before and those after the proband, and there was an excess of males born prior to the proband. Family studies showed a 2.4% risk for sibs born after the proband and an excess of affected relatives on the maternal side. Knowledge of rates of occurrence in relatives is useful for counseling and the interpretation of the results of alpha-fetoprotein screening.

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“…6 of Ferrer and Navarro [23] and in Choulot's [12] series in which 7 of the 9 surviving twins with either MCE or hydranencephaly were microcephalic. In a population of patients with microcephaly and mental retardation, Durkin et al [19,20] and Melnick [39] found a large proportion of twins with a his tory of a deceased co-twin. In these series, microcephaly does not refer to a true malfor mation, but rather to a sequel of clastic brain damage.…”

Section: Microcephalymentioning

confidence: 98%

Brain Damage in Monozygous Twins

Droullé²,

et al. 1990

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A series of 15 monochorionic twins with a great variety of cerebral lesions is reported. Seven cases illustrate the classical situation: the recipient twin was affected and his co-twin, the donor was macerated. In 5 cases, the lesions were described in the donor twin as well and once, as early as 22 weeks. The lesions were usually hypoxic-ischemic, in 2 they were hemorrhagic. In 1 case there was a malformation. Fetal US were performed in 11 cases and the diagnosis of either IUGR, death of a fetus and/or brain lesions in the survivor could be made in 10 cases and once as early as 21 weeks. In fetuses born alive, transfontanellar US or CT scan have confirmed the diagnosis made on fetal US. The pathogenesis of the lesions is not fully understood. Lesions in the recipient twin may result from emboli or thromboplastic material originating from the macerated co-twin. We suggest that blood pressure instability or episodes of severe hypotension might as well lead to brain and/or visceral lesions in the recipient twin. In the donor, the lesions result from hypotension and/or anemia. With improvement and generalization of imaging techniques, the vitality of the fetuses as well as biometric parameters and anatomical structures will be better controlled. However, in case of a fetal death, occurrence of lesions in the survivor is unpredictable and no uniform policy has been proposed yet. Studies with Doppler and continuous monitoring of funicular circulation should improve our knowledge on feto-fetal transfusion and permit to detect hemodynamic fluctuation or impairment.

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Sequential Fetus-Fetus Interaction and C.N.S. Defects

Cited by 10 publications

References 10 publications

Spontaneous abortion–high risk factor for neural tube defects in subsequent pregnancy

Spontaneous abortion–high risk factor for neural tube defects in subsequent pregnancy

Neural tube defects in Eastern Ontario and Western Quebec: Demography and family data

Brain Damage in Monozygous Twins

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