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Cruciat G, Nemeti GI, Popa-Stanila R, et al. Imaging diagnosis and legal implications of brain injury in survivors following single intrauterine fetal demise from monochorionic twins - a review of the literature. J Perinat Med. 2021;49(7):837-846doi: 10.1515/jpm-2020-0566.
Cruciat, G., Nemeti, G. I., Popa-Stanila, R., Florian, A., & Goidescu, I. G. (2021). Imaging diagnosis and legal implications of brain injury in survivors following single intrauterine fetal demise from monochorionic twins - a review of the literature. Journal of perinatal medicine, 49(7), 837-846. https://doi.org/10.1515/jpm-2020-0566
Cruciat, Gheorghe, et al. "Imaging diagnosis and legal implications of brain injury in survivors following single intrauterine fetal demise from monochorionic twins - a review of the literature." Journal of perinatal medicine vol. 49,7 (2021): 837-846. doi: https://doi.org/10.1515/jpm-2020-0566
Cruciat G, Nemeti GI, Popa-Stanila R, Florian A, Goidescu IG. Imaging diagnosis and legal implications of brain injury in survivors following single intrauterine fetal demise from monochorionic twins - a review of the literature. J Perinat Med. 2021 Apr 22;49(7):837-846. doi: 10.1515/jpm-2020-0566. Print 2021 Sep 27. PMID: 33882202.
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J Perinat Med. 2021 Apr 22;49(7):837-846. doi: 10.1515/jpm-2020-0566. Print 2021 Sep 27.

Imaging diagnosis and legal implications of brain injury in survivors following single intrauterine fetal demise from monochorionic twins - a review of the literature.

Journal of perinatal medicine

Gheorghe Cruciat, Georgiana Irina Nemeti, Roxana Popa-Stanila, Andreea Florian, Iulian Gabriel Goidescu

Affiliations

  1. Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Ha?ieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
  2. Department of Radiology, "Iuliu Ha?ieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.

PMID: 33882202 DOI: 10.1515/jpm-2020-0566

Abstract

Brain injury of the surviving twin from monochorionic pregnancies following intrauterine fetal demise during the second and third trimesters is a rare but severe complication. Monochorionicity and gestational age at the time of stillbirth seem to be decisive factors in terms of long-term neurologic outcome prediction for the survivor. Magnetic resonance imaging (MRI), diffusion weighted imaging (DWI) in particular, seem to bring the earliest and most accurate diagnosis. Ultrasound detection of brain damage is possible in later stages of fetal brain injury. It is essential to provide early diagnosis and multidisciplinary counsel to the parents to ensure informed decision making. For couples who choose to terminate pregnancy legislation related to late abortion might lead to further distress. Our paper aims to stress the importance of MRI DWI in the evaluation of surviving twins following single intrauterine fetal demise in monochorionic pregnancies and the delicate context of the medical professionals and parents facing this clinical situation, sometimes complicated by legal constraints.

© 2021 Gheorghe Cruciat et al., published by De Gruyter, Berlin/Boston.

Keywords: DWI MRI; brain injury; legal aspects; monochorionic; surviving twin

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