Skip Navigation


Human Reproduction Update Advance Access originally published online on May 19, 2009
Human Reproduction Update 2009 15(6):639-648; doi:10.1093/humupd/dmp019
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
15/6/639    most recent
dmp019v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Pharoah, P.O.D.
Right arrow Articles by Dundar, Y.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pharoah, P.O.D.
Right arrow Articles by Dundar, Y.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Monozygotic twinning, cerebral palsy and congenital anomalies

P.O.D. Pharoah1,4 and Y. Dundar2,3

1 Division of Public Health, University of Liverpool, Liverpool L69 3GB, UK 2 Liverpool Reviews and Implementation Group, Division of Clinical Effectiveness, University of Liverpool, Liverpool L69 3GB, UK 3 Rathbone Rehabilitation Centre, Mersey Care NHS Trust, Liverpool L13 4AW, UK

4 Correspondence address. Tel: +44-151-794-5577; Fax: +44-151-794-5272; E-mail: p.o.d.pharoah{at}liv.ac.uk

BACKGROUND: The majority of cases of cerebral palsy (CP) have their pathogenesis during fetal development and are a form of congenital anomaly, the aetiology of which is uncertain. Anomalous development of other organs evident at birth is also a congenital anomaly. A small proportion of these are known to be caused by chromosomal or gene abnormalities, environmental tetratogens and dietary deficiencies. The majority are of unknown aetiology.

METHODS: A review of monochorionic (MC) monozygotic (MZ) placentation in the pathogenesis of congenital anomalies and CP was conducted using the PubMed, MEDLINE, EMBASE and Cochrane databases.

RESULTS: Zygote division and MC placentation have serious implications for the development of both conceptuses. Most reports observe predominantly cerebral abnormalities in one or both conceptuses. These cerebral abnormalities often present as CP or other disabilities attributable to central nervous system impairment. In addition to the anomalies in central nervous system development, anomalies in the fetal development of a wide variety of other organs have been reported with MC MZ twinning.

CONCLUSIONS: CP and congenital anomalies share a common pathogenic mechanism attributable to MZ twinning. These abnormalities in singletons are coincident with very early loss of one conceptus. The quantitative contribution of monozygosity and monochorionicity to the genesis of CP and congenital anomalies needs to be made.

Key words: monozygosity / monochorionicity / cerebral palsy / congenital anomalies

Received on December 19, 2008; revised April 19, 2009; accepted on April 23, 2009


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.