Cerebral injury in monochorionic twins with selective intrauterine growth restriction and/or birthweight discordance.

OBJECTIVE: The objective of the study was to study the incidence of severe cerebral injury in monochorionic (MC) twins with selective intrauterine growth restriction (sIUGR) and/or birthweight discordance.

STUDY DESIGN: All MC twin pregnancies with 2 liveborn twins were included in the study. We excluded all cases with twin-to-twin transfusion syndrome (TTTS). Sequential cranial ultrasound scans were performed in all MC twin infants.

RESULTS: A total of 117 MC twin pairs were included in the study. The sIUGR of at least 1 fetus was found in 50 twin pregnancies (43%), and birthweight discordance of 25% or greater occurred in 26 twin pregnancies (22%). The overall incidence of severe cerebral injury was 3% (6/218). The incidence of severe cerebral injury in infants from twin pregnancies with and without sIUGR was 2% (2/94) and 3% (4/124), respectively (P = .62). The incidence of severe cerebral injury in infants with and without birthweight discordance was 0% (0/48) and 4% (6/170), respectively (P = .19).

CONCLUSION: The incidence of severe cerebral injury in MC twin pregnancies not complicated by TTTS with 2 liveborn twins is low. No association could be demonstrated with sIUGR or intertwin birthweight discordance of 25% or greater.