Original articlePatterns of cerebral injury and clinical presentation in the vascular disruptive syndrome of monozygotic twins
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2018, European Journal of Paediatric NeurologyCitation Excerpt :It was therefore hypothesised that the acute fall in blood pressure in the dying twin allows shunting of blood from the survivor, causing acute hypovolaemia, hypotension, hypoxia, acidosis and anaemia in that twin. Anaemia has been reported in the surviving twin at birth113,129,138 and the acute blood loss has been considered to be the main cause of perinatal death129 and/or brain damage.113,168,169 There is some evidence for acute anaemia in the surviving twin on fetal blood sampling, when the haematocrit may halve acutely from 35 to 40% to less than 20 in the surviving twin.168
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2009, Seminars in Fetal and Neonatal MedicineCitation Excerpt :Widespread selective neuronal cell death (in deep grey matter, brainstem and cord) may coexist on the basis of global forebrain ischaemia.59,60 Monozygous twinning predisposes to this type of injury,55,59,61 often afflicting the donor (Figs. 1 and 7). A similar global insult occurs in some types of birth asphyxia.62
Medicolegal issues in multiple pregnancy
2007, Seminars in Diagnostic PathologyCitation Excerpt :Monochorionic twins appear to be primarily at risk.20,39,44,46-54 At all gestational ages, the risk of cerebral palsy is higher in like-sex surviving cotwins.55 Abnormalities in surviving cotwins are usually attributed to the complex vascular anastomoses that occur in monochorionic gestations.
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