Postnatal cranial ultrasonographic findings in feto-fetal transfusion syndrome.
Our objective was a retrospective evaluation of cranial US in survivors of twin pregnancy with feto-fetal transfusion syndrome (FFTS), with knowledge of prenatal treatment and neonatal/postnatal clinical data. In 18 pregnancies with FFTS (January 1996 to May 2000), pregnancy management and outcome, and neonatal clinical/neurological data and follow-up (age of 3-7 months) were documented when available. Postnatal cranial US abnormalities were differentiated in prenatal and peri/postnatal lesions, respectively, in "donor" and "recipient." The statistical analysis used was Mann Whitney U test and Fisher's exact test. Overall pregnancy survival rate was 19 of 36 (53%); mors in utero occurred in five twin members. Gestational age at birth was significantly lower in FFTS after laser coagulation (13 of 18; p<0.05). Initial (<or=4 days of age) postnatal cranial US was abnormal in 13 of 27 cases: antenatal brain lesion in 9 of 13 patients (7 of 13 donors, 2 of 14 recipients); after treatment: antenatal hemorrhage (n=6), hydrocephaly (n=1), subependymal germinolysis (n=1), lenticulostriatal vasculopathy (n=1), evidence for brain atrophy (n=2), cystic periventricular leukomalacia in<3 days (n=1); peri/postnatal brain lesions in 4 of 13 patients (hemorrhage (n=3), and periventricular leukomalacia (n=1). Finally, an abnormal brain US was found in 18 patients. Twin pregnancies complicated with FFTS are high-risk pregnancies with antenatal and postnatal mortality and morbidity. In utero cranial hemorrhage dominated the antenatal brain insults; however, pregnancy survivors remain at risk for severe peripartal and/or postnatal brain insults.
Breysem
Luc
L
Department of Radiology, University Hospitals, Herestraat 49, 3000 Leuven, Belgium. luc.breysem@uz.kuleuven.ac.be
Naulaers
Gunnar
G
Deprest
Jan
J
Schoubroeck
Dominique Van
DV
Daniels
Hans
H
Lammens
Martin
M
Smet
Maria-Helena
MH
D001921:Brain / Q000002:abnormalities / Q000601:surgery; D004453:Echoencephalography; D005260:Female; D005330:Fetofetal Transfusion / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008429:Maternal Welfare; D011247:Pregnancy; D011644:Puerperal Disorders / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D016019:Survival Analysis; D013577:Syndrome; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial