Fetal MRI for assessment of complicated monochorionic gestations.

Aim: To demonstrate abnormalities found on fetal MRI in complicated monochorionic gestations and to discuss the adjunctive role of fetal MRI in the imaging diagnosis and management of these pregnancies. Method(s): Retrospective audit of all women referred to the Monash Health Fetal MRI service for evaluation of monochorionic twin gestations at >20 weeks following either spontaneous co - twin death or post-selective fetoscopic laser photocoagulation (SFLP) of placental anastomoses. Result(s): Fourteen women were referred for fetal MRI. A variety of findings were identified some of which were undiagnosed or nonspecific on ultrasound. These included polymicrogyria, dural sinus malformation, intraventricular haemorrhage, cerebral infarction, isolated ventriculomegaly and normal findings. Conclusion(s): Fetal MRI can provide additional for prognostication, counselling and further management of women with complicated monochorionic gestations as well as surrogate clinical follow-up data about the short term outcome of fetuses from pregnancies treated with SFLP. Fetuses that were the surviving donor in the setting of twin twin transfusion or co-twin death were at highest risk for cerebral malformations.