Short communication, Note
ENCEPHALOMALACIA AS A RESULT OF TWIN TO TWIN TRANSFUSION SYNDROME – CASE REPORT
Snježana Gverić-Ahmetašević
; Neonatal Intensive Care Unit, Department of Gynaecology and Obstetrics, Clinical Hospital Centre, Medical School University of Zagreb, Croatia
Ana Čolić
; Neonatal Intensive Care Unit, Department of Gynaecology and Obstetrics, Clinical Hospital Centre, Medical School University of Zagreb, Croatia
Tugomir Gverić
; Department of Surgery, General Hospital "Sveti Duh", Zagreb, Croatia
Abstract
Cerebral morbidity in twin to twin transfusion (TTTS) occurs often. Both donors and recipients are at risk of developing either ischemic or hemorrhagic lesions. Our patient was born from twin pregnancy at 32nd week of gestational age, after intrauterine fetal death of the second twin. The mother had gestational diabetes. After delivery the baby was pale, hypotonic, without spontaneous respirations, bradicardic, with generalized edema, with birth-weight 2230 grams. The blood count revealed heavy anemia. Seizures appeared at the fourth day of life. Ultrasound imaging (US) noted on first day of life hyperechogenicity of white and gray matter. Resistance index (RI) of anterior and middle cerebral artery revealed high systole spike almost without diastole (edema), and at 4th day of life there was a reperfusion with RI of 0,57. The first sign of leucomalacia appeared on 8th day. Ischemic leukomalacia of almost all telencephalon with hypoplastic corpus callosum were seen by US on 19th day of life. The finding was proved by magnetic resonance imaging. The child survived with serious neurological impairment.
Keywords
twin to twin transfusion syndrom (TTTS); encephalomalacia; cystic leukomalacia; twin pregnancy
Hrčak ID:
23526
URI
Publication date:
1.3.2008.
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