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CC BY-NC-ND 4.0 · Journal of Fetal Medicine 2021; 08(02): 151-155
DOI: 10.1007/s40556-021-00304-8
Case Reports

Diffuse Cortical Dysplasia in the Donor of Twin-to-Twin Transfusion Syndrome Following Fetoscopic Laser Photocoagulation: A Case Report

Kaori Miyana 
1   Department of Pediatrics, Japanese Redcross Medical Center, 4-1-22 Hiroo, 150-8935, Shibuya, Tokyo, Japan
,
Itaru Hayakawa
2   Division of Neurology, National Center for Child Health and Development, 2-10-1 Okura, 157-0074, Setagaya, Tokyo, Japan
,
Jin Muromoto
3   Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, 157-0074, Setagaya, Tokyo, Japan
,
Matsumoto Ayumi
4   Department of Pediatrics, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan
5   Department of Human Genetics, Center for Molecular Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan
,
Kazuhiro Muramatsu
1   Department of Pediatrics, Japanese Redcross Medical Center, 4-1-22 Hiroo, 150-8935, Shibuya, Tokyo, Japan
4   Department of Pediatrics, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan
,
Masaya Kubota
2   Division of Neurology, National Center for Child Health and Development, 2-10-1 Okura, 157-0074, Setagaya, Tokyo, Japan
6   Department of Pediatrics, Shimada Ryoiku Rehabilitation Center, 1-31-1 Nakazawa, 206-0036, Tama, Tokyo, Japan
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Abstract

Twin-to-twin transfusion syndrome (TTTS) is a severe gestational complication due to an imbalance of blood flow between monochorionic diamniotic twins. TTTS can cause brain damage, most commonly ischemic lesions, but there are only a few reports of cortical dysplasia. We report the case of a TTTS donor twin with diffuse cortical dysplasia. Fetoscopic laser photocoagulation was performed at 18 weeks of gestation, and no abnormalities were noted in the subsequent course of the pregnancy; however, infantile spasms developed at 4 months after birth, and brain magnetic resonance imaging revealed diffuse cortical dysplasia. It was bilateral and widespread. A genetic abnormality was suspected, but no pathogenic mutation was detected. Hypoperfusion may have altered the expression of guidance factors, resulting in abnormal cortical formation.

Keywords

Twin-to Twin Transfusion Syndrome - Cortical Dysplasia - Migration Disorder - Fetoscopic Laser Photocoagulation


Publication History

Received: 27 March 2021

Accepted: 27 May 2021

Article published online:
05 May 2023

© 2021. Society of Fetal Medicine. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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