Summary
A newborn with bilateral renal cortical necrosis and severe cerebral damage in association with a macerated stillborn twin is reported. The alterations in the kidneys and brain of the twin born alive suggest that the primary event took place before birth. Thromboplastic material and embolizing particles derived from the dead fetus may have passed the monoamnionic-monochorionic twin placenta and caused disseminated intravascular coagulation in the living twin, followed by infarction in other organ systems.
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References
Benirschke K (1961) Twin placenta in perinatal mortality. NY State J Med 61: 1499–1507
Benirschke K, Driscoll SG (1967) The pathology of the human placenta. Springer, New York
Dimmick JE, Hardwick DF, Ho-Yuan B (1971) A case of renal necrosis and fibrosis in the immediate newborn period. Am J Dis Child 122: 345–347
Goecke H, Samimi R (1982) Ein Fetus papyraceus bei Geminipartus am Termin. Geburtshilfe Frauenheilkd 42: 579
McKay DG (1965) Disseminated intravascular coagulation. Harper & Row, New York
Meinick M (1977) Brain damage in survivor after in utero death of monozygous co-twin. Lancet II: 187
Moore CM, McAdams AJ, Sutherland J (1969) Intrauterine disseminated intravascular coagulation a syndrome of multiple pregnancy with a dead twin fetus. J Pediatr 74: 523–528
Reismann LE, Pathak A (1966) Bilateral renal cortical necrosis in the newborn. Am J Dis Child 111: 541–543
Steiner PE, Lushbough CC (1941) Maternal pulmonary embolism by amniotic fluid as a course of obstetric shock and unexpected death in obstetrics. JAMA 117: 1245
Weiner AE, Reld DE, Roby CC (1949) The hemostatic activity of amniotic fluid. Science 110: 190
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Bulla, M., von Lilien, T., Goecke, H. et al. Renal and cerebral necrosis in survivor after in utero death of co-twin. Arch. Gynecol. 240, 119–124 (1987). https://doi.org/10.1007/BF02134045
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DOI: https://doi.org/10.1007/BF02134045