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Background: Monochorionic biamniotic (MC/BA) twin pregnancies are at higher risk for twin-to-twin transfusion syndrome (TTTS), selective intrauterine growth restriction (sIUGR) and structural defects., Material and Method: During an 18 months period all MC/BA twins referred to our unit for clinical surveillance were evaluated. Chorionicity was assessed based on the characteristics of the intertwin amniotic membrane. MC complicated cases were labeled either as, TTTS or sIUGR and classified according to severity. All cases were closely evaluated for structural defects., Results: There were 34 MC/BA pregnancies, from them 20 presented TTTS, 6 in a moderate stage of severity, and 14 severely affected. Four cases had sIUGR, all severely affected. Four pregnancies showed a structural defect, 2 cardiac, 1 urological, and 1 open neural tube defect. Six twin MC/BA pregnancies underwent gestation without complications., Conclusion: The presence of a MC/BA twin pregnancy warrants close monitoring, including a detailed anatomical review and hemodynamic assessment of the umbilical arteries and ductus venosus of both twins.

Background: Corpus callosum agenesis (CCA) is an uncommon entity, which can be diagnosed in utero. Uncertain prognosis makes prenatal counseling difficult. AIM. We have tried to establish a positive correlation between clinical history and imaging findings in patients with CCA., Patients and Methods: We retrospectively reviewed clinical data and imaging findings of patients with callosal agenesis diagnosed at our institution between December 1995 and September 2002., Results: Eight patients with CCA were found, five males and three females. Mean age at last clinical follow up was six years and six months, ranging from three months to 20 years. All diagnoses except for one were post natal. All patients underwent, at least, one magnetic resonance (MR) of the brain. Abnormal pregnancy was reported in three patients. Family history was unremarkable in all patients. Three patients were diagnosed with isolated CCA. One of these patients was asymptomatic at three months. Another had a slight language delay at seventeen months. The other patient had a mild developmental delay at five years. All other five patients had non isolated CCA and all were symptomatic, with variable clinical pictures: psicomotor developmental delay (4), epilepsy (4), hemiparesis (1), ocular apraxia (1), macrocephaly (2)., Conclusion: Non isolated CCA is likely to have a worse prognosis. This may be of significant value in prenatal counseling.

Introduction: The obstetric and neonatal technological advances have changed the frequency and syndromic classification of perinatal brain lesions., Objective: To study all prevalent patients during 1996, with perinatal or late intrauterine brain lesions, in the outpatient neuropediatric clinic at our hospital., Methods: Selection of patients according to neuroimaging findings, and/or neurological sequela with documented perinatal antecedent., Exclusion Criteria: a normal MRI, brain lesions of doubtful origin, or uncertain sequela with normal CT or echography studies. Descriptive study, and also analytical, using logistic regression to study the relationship between antecedents and sequela., Results: A total of 111 patients with: brain lesions due to hypoxic-ischemic encephalopathy (22 cases), lesions due to prematurity (29), late intrauterine infection or neonatal meningitis as the only cause of fixed neurological impairment (12), unexpected vascular brain lesions during the neonatal period (11), late intrauterine brain lesions (37). The neurological sequela observed were: cerebral palsy (68%), epilepsy (47%), mental retardation (45%), learning disorders in (34%) of those of school age and free from mental retardation, strabism (26%), microcephaly (19%), visual impairment (14%), hyperkinesis (10%). The neuroimaging findings were: focal lesions (45%), hydrocephaly (28%), intraventricular haemorrhage (22%), white matter lesions (24%), venous thrombosis (2%). The multivariable analysis showed, as the most noticeable finding, the relationship between the antecedent of mechanical ventilation and late development of hyperkinesis (OR: 10), in this sample of patients with severe sequela. Three patients should be noted: a case of late-onset dystonia secondary to a late intrauterine brain lesion, a child with exclusively cerebellar symptoms due to a destructive cerebellar lesion of prenatal onset, and a patient with an acquired perinatal biopercular lesion and pseudobulbar palsy as the only long-term sequelae.