Magnetic resonance imaging changes of brain injured survivors of multiple pregnancy complicated by single intrauterine fetal demise

Abstract

Background. Multiple pregnancy has increased risks for complications. The incidence of fetal anomalies in multiple pregnancies is also significantly higher than in single pregnancies. The syndrome of death of one fetus in multiple pregnancies is often combined with an increase in perinatal morbidity and mortality of second fetuses. Objective. To investigate and categorize the range of the surviving fetal brain damage by prenatal magnetic resonance imaging in case of single intrauterine fetal death of monochorionic twin. Design and methods. Seventeen patients with a monochorionic multiple pregnancy which complicated by single intrauterine fetal demise were included in retrospective study. All cotwins underwent ultrasound neurosonography and magnetic resonance imaging. Results. The were no structural pathological changes in 8 cases (47,1 %), while 4 (23,5 %) had only isolated moderate ventriculomegaly. In 5 cases (29,4 %) surviving fetuses from monochorionic diam-niotic twins had structural and morphological brain abnormalities. Conclusion. Brain injuries of the surviving co-twin after single intrauterine fetal demise in monochorionic pregnancy are mostly ischemic and manifest as periventricular leukomalacia in combination with ventriculomegaly.