A case of antenatal periventricular leukomalacia in monochorionic twin pregnancy complicated with twin-to-twin transfusion syndrome.

Kang, Hee Seok; Yang, Soon Ha; Oh, Sung Hee; Kang, Byung Hee; Rho, Cheong Rae; Kim, Jong Hwa

Case Report

Korean Journal of Obstetrics & Gynecology 2002;45(5):841-845.
Published online May 1, 2002.

A case of antenatal periventricular leukomalacia in monochorionic twin pregnancy complicated with twin-to-twin transfusion syndrome.

Hee Seok Kang, Soon Ha Yang, Sung Hee Oh, Byung Hee Kang, Cheong Rae Rho, Jong Hwa Kim

Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

Nearly 100% of monochorionic twin pregnancies have vascular anastomoses and a fourth of those has clinical features of twin-to-twin transfusion syndrome. Cerebral palsy, microcephaly, porencephaly, and multicystic periventricular leukomalacia are serious antenatal neurologic complications associated with vascular communications in monochorionic twin gestation. It is most likely that such neurological damage is caused by intrauterine cerebral ischemic necrosis. The intermittent blood flow reversal or sudden hypotension in one twin, or emboli of thromboplastic material originating in the dead fetus could cause in utero cerebral damage in the other twin. In this report, we present a case of antenatal periventricular leukomalacia in monochorionic twin pregnancy complicated with twin-to-twin transfusion syndrome.

Key Words: Monochorionic twin, Twin-to-twin transfusion syndrome, Antenatal periventricular leukomalacia