MRI prior to laser photocoagulation; GA 19w6d
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Two fetuses present.
Lower twin: smaller and stuck against the uterine wall with its head positioned nearest the cervix. This is the donor twin. There is borderline asymmetric lateral ventriculomegaly with the left lateral ventricular trigone measuring 10 mm and the right 8 mm.
Upper twin: surrounded by a large amount of amniotic fluid and was highly mobile as a result, during the examination. 3 mm focus of susceptibility related signal loss and subtle localised brain parenchymal volume loss in the left frontoparietal region. The findings are most consistent with a small, established haemorrhagic cortical infarct. Generalised symmetric widening of the CSF spaces is consistent with the recipient status of this twin and is a well recognised and often transient finding in such fetuses. Otherwise normal apperance of the brain and normal cerebral biometry.
The deepest pocket of amniotic fluid surrounding this twin is approximately 10 cm.
Placenta: The placenta is anterior and somewhat thin for this gestation measuring 16 mm in maximum AP diameter.