Spontaneous septostomy of the dividing membrane in MoDi gestations is a rare condition that poses diagnostic and management challenges.

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The majority of patients with fetal gastroschisis were delivered before 37 weeks of gestation with a significant proportion delivering due to spontaneous onset of preterm labor. In addition to antepartum surveillance for fetal well-being, monitoring patients for symptoms and signs of preterm labor is recommended.

The incidence of maternal hypotension was low and did not differ following antepartum IV labetalol versus hydralazine use. These data should reassure providers about the use of parenteral labetalol and hydralazine for the treatment of severe hypertension.

Objective: The objective of this study was to compare alterations in the middle cerebral artery (MCA) pulsatility index (PI) and mean velocity (V mean ) after laser surgery for twin-twin transfusion syndrome (TTTS).Study Design: MCA Doppler studies were conducted 1 day before and after laser surgery for TTTS. The pre-and postoperative mean (standard deviation) of the MCA PI and V mean z-scores of the recipient and donor fetuses were calculated and compared. Data were analyzed using paired testing and multivariable linear regression models.Results: A total of 103 patients met the study criteria. Recipients' MCA PI increased from À1.29 (1.20) preoperatively to 0.14 (1.52) postoperatively (P<0.0001), whereas the donors' PI did not change significantly (À0.31 (1.67) to À0.67 (1.29); P ¼ 0.12). There was no significant difference between preoperative and postoperative MCA V mean in donors (0.39 (0.83) and 0.38 (0.93), respectively; P ¼ 0.5048) or recipients (0.60 (0.74) and 0.63 (0.90), respectively; P ¼ 0.5324).Conclusions: Despite the changes in the MCA PI after laser surgery for TTTS, the MCA V mean remained constant. These findings may suggest some autoregulatory capacity in the cerebral vessels of the mid-trimester fetus.