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Dr Owen
Dr Owen, Board Certified OB/GYN
Category: OB GYN
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Experience:  Board certified Ob/Gyn
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My daughter is 20wks pregnant with identical twins, sadly one

Customer Question

My daughter is 20wks pregnant with identical twins, sadly one twin died at 18wks resulting in the surviving twin needing a blood transfusing which it had the next day.
What are the chances of the surviving twin being born without any neurogical or physical damage?. They have been offered a mri scan at 24wks to see if there is any obvious signs of brain damage.
They need to make an informed decision but have been given no answers by medical
professionals
Please help.
Submitted: 2 years ago.
Category: OB GYN
Expert:  Dr Owen replied 2 years ago.
Hello,

This sounds like your daughter's pregnancy is a Monochorionic Twin to Twin Transfusion - meaning they are identical twins - and the bigger twin usually dies and the smaller twin usually survives AS LONG as there is a transfusion which it sounds like the baby got.
So, honestly it is very difficult to say - but usually as long as the heart beat was there in the surviving twin - usually that twin is doing very well - and there is minimal neurological injury - but usually these injuries take years to notice if they have existed - as this technology of transfusing a baby IN the Womb is still fairly new and hence following these children that have survived are very few in number - but those that have survived so far have done well.

I hope that helps
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Customer: replied 2 years ago.

They were told is was the smaller twin that died at 18 wk scan it measured 16wks and there didn't seem to be much movement.


Would there have been significant loss of oxgen due to baby dying that would cause surviving twin to have brain damage? that's what they are being told, Also a chance of cerebal palsy.


 


My daughter got scanned yesterday surviving baby seems fine, lots of movement, Fluid looks ok.


 


It was twin to twin syndrome.


 

Expert:  Dr Owen replied 2 years ago.
There is about a 2 to 4 times the chance of CP - Cerebral Palsy with a surviving twin, and the fact the donor twin died (the smaller twin) that is usually more concerning - usually the larger (the receipient twin) dies and with more favorable odds.
But the only way to really know if a baby has CP is once it is born - there is no testing for the baby once in the uterus, only once the baby is born.

So at this point it is a matter of taking a chance.

I wish you well
If you have more questions, please ask
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Expert:  Dr Owen replied 2 years ago.
Essentially there are other things too that you should know about - besides CP.
There could be problems with neurodevelopment, vision problems, Hearing problems - and these are big problems that can require a life time of physical therapy to overcome.

I with your family well
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