title: Brain damage to the survivor within 30 min of co-twin demise in monochorionic twins.
abstract: Single fetal death in a twin pregnancy in the late second or early third trimester is associated with significant morbidity and mortality rate in the surviving co-twin, especially in monochorionic twin pregnancies. The common causes are twin-to-twin transfusion syndrome, chromosomal abnormalities, and congenital anomalies of the fetus or anomalies of the umbilical cord-placenta. Here we report a case of monochorionic twin pregnancy in which one fetus had a single umbilical artery (SUA) while the co-twin had two umbilical arteries. The twin with SUA died in utero at the 30th week of gestation and the other fetus was delivered by cesarean section immediately due to fetal distress diagnosed by cardiotocography. Disseminated intravascular coagulation and multicystic encephalomalacia have been observed in the surviving neonate. This case and review of the literature suggest that neurologic complication rates are also increased in monochorionic twin pregnancies with single fetal demise despite the immediate delivery as in our case.
authors.affiliation: Kartal Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey. ykarageyim@yahoo.com
authors.forename: A Yasemin
authors.initials: AY
authors.lastname: Karageyim Karsidag
authors.forename: Bulent
authors.initials: B
authors.lastname: Kars
authors.forename: Ramazan
authors.initials: R
authors.lastname: Dansuk
authors.forename: Olus
authors.initials: O
authors.lastname: Api
authors.forename: Orhan
authors.initials: O
authors.lastname: Unal
authors.forename: M Cem
authors.initials: MC
authors.lastname: Turan
authors.forename: Gokhan
authors.initials: G
authors.lastname: Goynumer
mesh_terms: D000328:Adult; D001927:Brain Diseases / Q000209:etiology*; D015148:Cardiotocography; D002585:Cesarean Section; D004200:Diseases in Twins / Q000000981:diagnostic imaging / Q000401:mortality*; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis; D004678:Encephalomalacia / Q000175:diagnosis; D005260:Female; D005313:Fetal Death / Q000150:complications*; D005316:Fetal Distress / Q000175:diagnosis; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000002:abnormalities