{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:00:42Z","timestamp":1786118442375,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003579","name":"University of Toronto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003579","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Severe brain injury has been reported following fetoscopic laser ablation (FLA) for twin\u2010to\u2010twin transfusion syndrome (TTTS), but imaging patterns and temporal evolution remain poorly defined. This study aimed to characterize the progression of severe brain injury after FLA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective case series of TTTS pregnancies with severe brain injury identified after FLA at the Ontario Fetal Center (June 2023\u2013March 2025). FLA was performed for Quintero stage\u00a0\u2265\u00a0II and selected stage I cases. Severe abnormalities were defined as severe intraventricular haemorrhage or destructive lesions. Serial ultrasound and fetal MRI were reviewed and categorized as early (&lt;\u00a04\u00a0weeks) or late (\u2265\u00a04\u00a0weeks) post\u2010FLA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifteen fetuses from 14 pregnancies were identified. Mean gestational age at FLA was 19.7\u00a0\u00b1\u00a03.2\u00a0weeks; 66.7% were stage III\u2013IV and 60% were donor twins. Early imaging (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a08) most commonly showed periventricular haemorrhagic infarction (62.5%) and cerebellar haemorrhage (25.0%). Late imaging (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a013) predominantly demonstrated cerebral volume loss (76.9%), often involving the parietal lobes, with polymicrogyria (38.5%) and Wallerian degeneration (30.8%). Findings remained unchanged after 4\u00a0weeks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Brain injury after FLA evolves from acute haemorrhagic\/ischaemic insults to irreversible destructive changes. These preliminary findings suggest a consistent pattern of injury that warrants further prospective study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.70202","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T05:52:05Z","timestamp":1782193925000},"page":"1455-1467","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fetal Brain Abnormalities Following Laser Surgery for\u00a0Twin\u2010to\u2010Twin Transfusion Syndrome: Imaging Patterns and Evolution"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7388-1414","authenticated-orcid":false,"given":"Yada","family":"Kunpalin","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit Department of Obstetrics &amp; Gynaecology Mount Sinai Hospital Toronto  Toronto Ontario Canada"},{"name":"Ontario Fetal Centre Mount\u00a0Sinai Hospital  Toronto Ontario Canada"},{"name":"University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1075-5952","authenticated-orcid":false,"given":"Elka","family":"Miller","sequence":"additional","affiliation":[{"name":"Ontario Fetal Centre Mount\u00a0Sinai Hospital  Toronto Ontario Canada"},{"name":"University of Toronto  Toronto Ontario Canada"},{"name":"Department of Diagnostic Imaging and Interventional Radiology Department of Medical Imaging Hospital for Sick Children  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Larsen","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Department of Obstetrics &amp; Gynaecology Mount Sinai Hospital Toronto  Toronto Ontario Canada"},{"name":"Ontario Fetal Centre Mount\u00a0Sinai Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamini","family":"Raghuram","sequence":"additional","affiliation":[{"name":"Ontario Fetal Centre Mount\u00a0Sinai Hospital  Toronto Ontario Canada"},{"name":"University of Toronto  Toronto Ontario Canada"},{"name":"Division of Neonatology Department of\u00a0Paediatrics Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Windrim","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Department of Obstetrics &amp; Gynaecology Mount Sinai Hospital Toronto  Toronto Ontario Canada"},{"name":"Ontario Fetal Centre Mount\u00a0Sinai Hospital  Toronto Ontario Canada"},{"name":"University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimrah","family":"Abbasi","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Department of Obstetrics &amp; Gynaecology Mount Sinai Hospital Toronto  Toronto Ontario Canada"},{"name":"Ontario Fetal Centre Mount\u00a0Sinai Hospital  Toronto Ontario Canada"},{"name":"University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Ryan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Department of Obstetrics &amp; Gynaecology Mount Sinai Hospital Toronto  Toronto Ontario Canada"},{"name":"Ontario Fetal Centre Mount\u00a0Sinai Hospital  Toronto Ontario Canada"},{"name":"University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim Van","family":"Mieghem","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Department of Obstetrics &amp; Gynaecology Mount Sinai Hospital Toronto  Toronto Ontario Canada"},{"name":"Ontario Fetal Centre Mount\u00a0Sinai Hospital  Toronto Ontario Canada"},{"name":"University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6352-4846","authenticated-orcid":false,"given":"Shiri","family":"Shinar","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Department of Obstetrics &amp; 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