PEDIATRICS Vol. 96 No. 3 September 1995, pp. 521-523
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Fetal Hypokinesia Syndrome in the Monochorionic Pair of a Triplet Pregnancy Secondary to Severe Disruptive Cerebral Injury

Jeffrey M. Perlman MB1, Dennis K. Burns MD2, Diane M. Twickler MD3, and Arthur G. Weinberg MD4

1 Departments of Pediatrics and Obstetrics and Gynecology
2 Department of Pathology
3 Departments of Obstetrics and Gynecology and Radiology
4 Department of Pathology, University of Texas Southwestern Medical Center, Dallas

We report a set of triplets, two of whom were monochorionic diamnionic and demonstrated cerebellar hypoplasia and progressive arthrogryposis on an antenatal sonogram. At delivery the infants exhibited a Pena-Shokier phenotype. At autopsy, the twins were concordant for severe disruptive lesions of the cerebrum. The mechanism resulting in the devastating symmetric lesions may have been a transient cerebral vascular compromise associated with placenta vascular anastomoses characteristic of monochorionic twinning. This report accentuates the vulnerability of the monochorionic twin for ischemic cerebral injury.

Submitted on September 23, 1994
Accepted on December 9, 1994




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