Biomaterial Database

Diffuse brain damage caused by acute twin-twin transfusion during late pregnancy. 1998

H Wada, and K Nunogami, and T Wada, and Y Niida, and A Yachie, and S Koizumi

Department of Pediatrics, School of Medicine, Faculty of Medicine, Kanazawa University, Japan. pedialib@med.kanazawa-u.ac.jp

BACKGROUND Monoamniotic twinning is a relatively rare event with increased antenatal and perinatal mortality. We describe a brain damage detected in a surviving monoamniotic twin after intrauterine death of the co-twin at 37 weeks of gestation. RESULTS Severe entanglement and knotting of the umbilical cords was apparent at the time of delivery and a portion of the cord to the dead twin was narrowed significantly. It was suggested that transfer of blood occurred across placental anastomoses from the survivor to the dead fetus, resulting in transient but severe hypovolemia in the survivor. It is difficult to prevent this type of brain damage because the course of acute twin-twin transfusion is very rapid and the damage has already occurred by the time the death of the twin is diagnosed. CONCLUSIONS We suggest that elective delivery should be considered in cases of monoamniotic twin pregnancies with additional risk factors.

UI	MeSH Term	Description	Entries
D011247	Pregnancy	The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.	Gestation,Pregnancies
D001925	Brain Damage, Chronic	A condition characterized by long-standing brain dysfunction or damage, usually of three months duration or longer. Potential etiologies include BRAIN INFARCTION; certain NEURODEGENERATIVE DISORDERS; CRANIOCEREBRAL TRAUMA; ANOXIA, BRAIN; ENCEPHALITIS; certain NEUROTOXICITY SYNDROMES; metabolic disorders (see BRAIN DISEASES, METABOLIC); and other conditions.	Encephalopathy, Chronic,Chronic Encephalopathy,Chronic Brain Damage
D005260	Female		Females
D005313	Fetal Death	Death of the developing young in utero. BIRTH of a dead FETUS is STILLBIRTH.	Fetal Mummification,Fetal Demise,Death, Fetal,Deaths, Fetal,Demise, Fetal,Fetal Deaths,Mummification, Fetal
D005330	Fetofetal Transfusion	Passage of blood from one fetus to another via an arteriovenous communication or other shunt, in a monozygotic twin pregnancy. It results in anemia in one twin and polycythemia in the other. (Lee et al., Wintrobe's Clinical Hematology, 9th ed, p737-8)	Cross-Transfusion, Intrauterine,Intrauterine Cross-Transfusion,Twin Transfusion,Twin Transfusion Syndrome,Twin-to-Twin Transfusion,Fetal Transfusion Syndrome,Fetofetal Transfusion Syndrome,Twin Twin Transfusion Syndrome,Twin-to-Twin Transfusion Syndrome,Cross Transfusion, Intrauterine,Fetal Transfusion Syndromes,Fetofetal Transfusion Syndromes,Fetofetal Transfusions,Intrauterine Cross Transfusion,Intrauterine Cross-Transfusions,Syndrome, Fetal Transfusion,Syndrome, Fetofetal Transfusion,Syndrome, Twin Transfusion,Syndrome, Twin-to-Twin Transfusion,Transfusion Syndrome, Fetal,Transfusion Syndrome, Fetofetal,Transfusion Syndrome, Twin,Transfusion Syndrome, Twin-to-Twin,Transfusion, Fetofetal,Transfusion, Twin,Transfusion, Twin-to-Twin,Twin Transfusion Syndromes,Twin Transfusions,Twin to Twin Transfusion,Twin to Twin Transfusion Syndrome,Twin-to-Twin Transfusion Syndromes,Twin-to-Twin Transfusions
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults
D014430	Twins, Monozygotic	Two off-spring from the same PREGNANCY. They are from a single fertilized OVUM that split into two EMBRYOS. Such twins are usually genetically identical and of the same sex.	Twins, Identical,Identical Twin,Identical Twins,Monozygotic Twin,Monozygotic Twins,Twin, Identical,Twin, Monozygotic
D016216	Ultrasonography, Prenatal	The visualization of tissues during pregnancy through recording of the echoes of ultrasonic waves directed into the body. The procedure may be applied with reference to the mother or the fetus and with reference to organs or the detection of maternal or fetal disease.	Fetal Ultrasonography,Prenatal Diagnosis, Ultrasonic,Ultrasonography, Fetal,Diagnosis, Prenatal Ultrasonic,Diagnosis, Ultrasonic Prenatal,Prenatal Ultrasonic Diagnosis,Prenatal Ultrasonography,Ultrasonic Diagnosis, Prenatal,Ultrasonic Prenatal Diagnosis,Diagnoses, Prenatal Ultrasonic,Diagnoses, Ultrasonic Prenatal,Prenatal Diagnoses, Ultrasonic,Prenatal Ultrasonic Diagnoses,Ultrasonic Diagnoses, Prenatal,Ultrasonic Prenatal Diagnoses