596 Mri of the Brain of Twins with Twin Twin Transfusion Syndrome. (TTTS)

Abstract

Introduction: Perinatal mortality and morbidity rates are higher in twins than in singletons. Monochorionic twins have a high risk of low birth weight, preterm delivery and neurologic morbidity. TTTS occurs as a serious complication in 10 to 15% of monochorionic diamniotic (MCDA) pregnancies. The assessment of term corrected MRI brain has not been investigated to the best of our knowledge in this specific area to date.

Objective: The aim of this study was to evaluate term corrected MRI brain as a surrogate short-term marker for neonatal outcome of twins with TTTS.

Study Design: We conducted a prospective trial in the Rotunda hospital which had ethical approval. We obtained informed consent from parents of infants in 3 groups: 1:Twin pregnancies that underwent intrauterine laser. 2: MCDA twins who did not meet the clinical criteria for TTTS. 3: Dichorionic diamniotic (DCDA) twins. The MRIs took place at term using a Siemens 1.5 Tesla MRI scanner. T1, T2, ADC and diffusion images were acquired.

Results:10 sets of twins and 1 set of triplets have consented. (n=23). 7 sets have reached term and have had an MRI (n=14). In our cohort gestation ranged from 25 weeks to 34 weeks. To date 2 MRIs have been reported as abnormal. 1 sibling in the laser group and 1 sibling in the DCDA group.

Conclusion: This group of infants and their MRI findings represent a spectrum of findings in multiple births. Follow up at 2 years with Bayleys is planned and will ascertain any long-term correlation.

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