rss
Arch Dis Child Fetal Neonatal Ed 2004;89:F315-F320 doi:10.1136/adc.2003.037309
  • Original article

Preterm twin gestation and cystic periventricular leucomalacia

  1. B Resch1,
  2. A Jammernegg1,
  3. E Vollaard2,
  4. U Maurer1,
  5. W D Mueller1,
  6. B Pertl3
  1. 1Division of Neonatology, Department of Paediatrics, University Hospital Graz, Austria
  2. 2University Hospital Groningen, the Netherlands
  3. 3Department of Obstetrics and Gynaecology, University Hospital Graz
  1. Correspondence to:
    Dr Resch
    Division of Neonatology, Department of Paediatrics, University Hospital Graz, Auenbruggerplatz 30, 8036 Graz, Austria; bernhard.reschmeduni-graz.at
  • Accepted 23 October 2003

Abstract

Objective: To identify risk factors for the development of cystic periventricular leucomalacia (PVL) in twin gestation.

Design: Retrospective case-control study.

Setting: Tertiary care university hospital, Department of Paediatrics, Division of Neonatology, Graz, Austria.

Patients: Preterm twin gestations with one sibling having developed cystic PVL, diagnosed by ultrasound scans, compared with their co-twins without PVL, in hospital between 1988 and 2000.

Main outcome measures: Perinatal and postnatal risk factors for the development of PVL.

Results: Eighteen preterm twin gestations were included. Monochorionicity was evident in 47% of the pregnancies, and twin to twin transfusion syndrome occurred in two cases (11%). Fetal distress correlated inversely with PVL (15% v 53%, p  =  0.019, relative risk (RR)  =  2.057, 95% confidence interval (CI)  =  1.067 to 3.968). Hypocarbia with Pco2 levels below 30 mm Hg (4 kPa) was diagnosed in 29% of the cases compared with 6% of the controls (p  =  0.038, RR  =  1.944, 95% CI  =  1.113 to 3.396). There were no significant differences between groups with regard to premature rupture of the membranes, early onset infection, respiratory distress syndrome, mechanical ventilation, arterial hypotension, persistent ductus arteriosus, and hyperbilirubinaemia. Asphyxia was only evident in three controls. Three infants died and another three were lost to follow up. None of the cases compared with 62% of the controls were diagnosed as having developed normally (p < 0.001), and 14 cases (82%) compared with two controls (15%) developed cerebral palsy (p < 0.001).

Conclusion: Hypocarbia was the only risk factor strongly associated with cystic PVL. The general outcome of the infants was poor.

Footnotes

    This Article

    1. Abstract
    2. Full text
    3. PDF

    Responses

    1. Submit a response
    2. No responses published

    Register for free content

    The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

    Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.