{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T21:17:19Z","timestamp":1792531039531,"version":"4.5.0"},"reference-count":12,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,2,1]],"date-time":"2015-02-01T00:00:00Z","timestamp":1422748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:title><jats:styled-content style=\"fixed-case\">ABSTRACT<\/jats:styled-content><\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the incidence, type and severity of cerebral injury in the surviving monochorionic (<jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content>) cotwin after single fetal demise in twin pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All <jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content> pregnancies with single fetal demise that were evaluated at the Leiden University Medical Center between 2002 and 2013 were included. Perinatal characteristics, neonatal outcome and the presence of cerebral injury, observed on neuroimaging, were recorded for all cotwin survivors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 49 <jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content> pregnancies with single fetal demise, including one <jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content> triplet, were included in the study (<jats:italic>n<\/jats:italic>\u2009=\u200950 cotwins). Median gestational age at occurrence of single fetal demise was 25\u2009weeks and median interval between single fetal demise and live birth was 61\u2009days, with a median gestational age at birth of 36\u2009weeks. Severe cerebral injury was diagnosed in 13 (26%) of the 50 cotwins and was detected antenatally in 4\/50 (8%) and postnatally in 9\/50 (18%) cases. Cerebral injury was mostly due to hypoxic\u2010ischemic injury resulting in cystic periventricular leukomalacia, middle cerebral artery infarction or injury to basal ganglia, thalamus and\/or cortex. Risk factors associated with severe cerebral injury were advanced gestational age at the occurrence of single fetal demise (odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>), 1.14 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.01\u20131.29) for each week of gestation; <jats:italic>P<\/jats:italic>\u2009=\u20090.03), twin\u2013twin transfusion syndrome developing prior to single fetal demise (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 5.0 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.30\u201319.13); <jats:italic>P<\/jats:italic>\u2009=\u20090.02) and a lower gestational age at birth (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 0.83 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.69\u20130.99) for each week of gestation; <jats:italic>P<\/jats:italic>\u2009=\u20090.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Single fetal demise in <jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content> pregnancies is associated with severe cerebral injury occurring in 1 in 4 surviving cotwins. Routine antenatal and postnatal neuroimaging, followed by standardized long\u2010term follow\u2010up, is mandatory. Copyright \u00a9 2014 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.14722","type":"journal-article","created":{"date-parts":[[2014,11,6]],"date-time":"2014-11-06T08:17:16Z","timestamp":1415261836000},"page":"294-300","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":57,"title":["Single fetal demise in monochorionic pregnancies: incidence and patterns of cerebral injury"],"prefix":"10.1002","volume":"45","author":[{"given":"J. M. M.","family":"van Klink","sequence":"first","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"van Steenis","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. J.","family":"Steggerda","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Genova","sequence":"additional","affiliation":[{"name":"Division of Fetal Medicine, Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Sueters","sequence":"additional","affiliation":[{"name":"Division of Fetal Medicine, Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Oepkes","sequence":"additional","affiliation":[{"name":"Division of Fetal Medicine, Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Lopriore","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0028-2243(94)90064-7"},{"key":"e_1_2_5_3_1","first-page":"1","article-title":"Single fetal death in twin gestations","author":"Blickstein I","year":"2012","journal-title":"J Perinat Med"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31822f129d"},{"key":"e_1_2_5_5_1","first-page":"403","volume-title":"Neurology of the Newborn","author":"Volpe JJ","year":"1995"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0166-4328(05)80189-5"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.56.12.900"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2005.06.004"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032597"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000354344"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000356433"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31825b9841"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2011.07.007"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.14722","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.14722","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.14722","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T19:32:10Z","timestamp":1695497530000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.14722"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2015,3]]}},"alternative-id":["10.1002\/uog.14722"],"URL":"https:\/\/doi.org\/10.1002\/uog.14722","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2]]},"assertion":[{"value":"2014-08-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-10-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-02-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}