ISSN:
1437-9813
Keywords:
Monochorionic twin
;
Multiple intestinal atresias
;
Disseminated vascular coagulation
;
Encephalomalacia
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract A twin infant who survived the death of his monochorionic co-twin in utero and was born with multiple jejunoileal atresias and severe cerebral damage is reported. The pathogenesis of these defects is discussed in the light of previously reported similar cases. The incidence of severe brain damage in twins born alive after the intrauterine death of a monochorionic co-twin is high, suggesting brain destruction by embolization of thromboplastin-rich material from the dead fetus via placental vascular anastomoses. A similar mechanism could be evoked in the present case to account for the intestinal atresias, which likely occurred after the 22nd gestational week, i.e. after the normal permeabilization of the embryonic gut. In the light of this observation and similar ones made by others, it is clear that surgical management of congenital defects during the neonatal period should be influenced by the knowledge of in-utero death of a monochorionic co-twin during the second half of gestation.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00179582
Permalink
