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Natural history of twin disruption sequence
Author(s) -
Zankl Andreas,
Brooks Daniela,
Boltshauser Eugen,
Largo Remo,
Schinzel Albert
Publication year - 2004
Publication title -
american journal of medical genetics part a
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.064
H-Index - 112
eISSN - 1552-4833
pISSN - 1552-4825
DOI - 10.1002/ajmg.a.20680
Subject(s) - anastomosis , monochorionic twins , medicine , twin pregnancy , natural history , fetus , placenta , pregnancy , surgery , biology , genetics
Intrauterine death of one fetus in a monochorionic twin pregnancy is associated with high morbidity and mortality in the surviving cotwin. Thromoboplastic material from the dead twin may pass to the circulation of the living twin via placental anastomoses and cause tissue necrosis by direct embolization or by activating intravascular coagulation. Alternatively, acute blood loss into the dying twin through placental anastomoses may result in hypotension and hypoxic‐ischemic damage to cerebral and visceral tissue in the surviving twin. The resulting clinical picture is referred to as twin disruption sequence. Affected twins have rarely been followed beyond the neonatal period and the long‐term development of such children is unknown. Here, we present a natural history and neurological assessment of 18 patients with twin disruption sequence, whom we have followed over several months to years. © 2004 Wiley‐Liss, Inc.