Meeting paperSMFM paperIntracranial magnetic resonance imaging findings in the surviving fetus after spontaneous monochorionic cotwin demise
Section snippets
Materials and Methods
A total of 47 cases of cotwin demise in monochorionic twin pregnancies were identified from a database consisting of all fetal MRI examinations performed at the University of California San Francisco (UCSF) between 1997-2007. Twenty-five of these cases were associated with an intervention (fetal RFA or placental ablation) and were excluded from the study. An additional case was excluded because of the lack of a comparison ultrasound after cotwin demise. The remaining 21 cases comprise our study
Results
The mean gestational age at the time of cotwin demise was 196/7 weeks (range 124/7 weeks-265/7 weeks) with an average interval of 43/7 weeks between the time of cotwin demise and fetal MRI (range 0-121/7 weeks). Intracranial abnormalities were visualized by antenatal MRI after cotwin demise in 7 of the 21 cases, the majority of which had a normal ultrasound (Table). These abnormalities included a unilateral infarct with developing polymicrogyria (Figure 1), small focal injury in the left
Comment
The ability to predict neurologic sequelae of a surviving twin prenatally by sonographic findings was first reported in 1989.13 Since then, several studies have demonstrated a correlation between sonographic findings and neonatal outcomes, including deficits at up to 6 years of age.7 Ischemic lesions have variable presentation on ultrasound, but even subtle abnormalities, such as polymicrogyria, have been reported.14 Recently, fetal MRI has proven to be a useful modality in the visualization of
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Cite this article as: Jelin AC, Norton ME, Bartha AI, et al. Intracranial magnetic resonance imaging findings in the surviving fetus after spontaneous monochorionic cotwin demise. Am J Obstet Gynecol 2008;199:398.e1-398.e5.
Reprints are not available from the authors.