Abstract
Three infants with intrauterine disseminated intravascular coagulation are presented.Each was the product of a twin pregnancy with a macerated sibling. Renal cortical and cerebral necrosis were the predominant features. Two other similar patients have been previously reported. It appears likely that the feto-fetal exchange of thromboplastic material from a dead fetus through vascular shunts in a monochorionic placenta is responsible for this syndrome. With conservative management, the renal cortical necrosis may not necessarily be fatal, but the prognosis is probably poor because of the severity of the cerebral damage. Three infants with intrauterine disseminated intravascular coagulation are presented.Each was the product of a twin pregnancy with a macerated sibling. Renal cortical and cerebral necrosis were the predominant features. Two other similar patients have been previously reported. It appears likely that the feto-fetal exchange of thromboplastic material from a dead fetus through vascular shunts in a monochorionic placenta is responsible for this syndrome. With conservative management, the renal cortical necrosis may not necessarily be fatal, but the prognosis is probably poor because of the severity of the cerebral damage.
Published Version
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