Citation

Robinson A, Teoh M, Edwards A, Fahey M, Goergen S. Prenat Diagn 2017; 37(6): 611-627.

Affiliation

Monash Imaging, Monash Health, Clayton, Victoria, Australia.

Copyright

(Copyright © 2017)

DOI

10.1002/pd.5059

PMID

28444780

Abstract

OBJECTIVE: To determine the additional diagnostic information provided by prenatal (fetal) magnetic resonance imaging (pMRI) following tertiary ultrasound (US) for fetal cranial abnormalities in complicated monochorionic gestations (cMCGs) METHODS: Women with cMCGs complicated by twin - twin transfusion syndrome (TTTS), co-twin demise (CD), selective intrauterine growth restriction (sIUGR), and / or twin anemia - polycythemia sequence (TAPS) who were referred for pMRI after tertiary US were included. PRIMARY OUTCOME: additional diagnostic information by pMRI that changed prognostic counselling.

RESULTS: 33 women with 48 live fetuses had pMRI at a median of 25 weeks (range: 21 - 29). 3/10 survivors of spontaneous CD, 1/8 survivors of CD after TTTS and 1/30 co-survivors had diagnostic information added by pMRI that altered counselling; US was normal in 2 and in the other 3 under- represented parenchymal injury (5/33 = 15%; 95% CI +/- 0.27 - 0.03). Additional findings included occipital lobe infarction, hemispheric injury, dural sinus thrombosis, ischemia producing polymicrogyria, and intraventricular hemorrhage. Another 8 /33 women had additional information provided by pMRI that did not alter counselling.

CONCLUSION: pMRI resulted in changed prognostic counselling in 5/33 pregnancies. Evaluation of incorporation of pMRI into routine surveillance of complicated MCGs is needed.

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Language: en