Concordant body stalk anomaly in a monoamniotic twin pregnancy at 9 weeks

Rovida, P.L.; Frusca, T.; Fichera, A.

doi:10.1002/pd.4392

Cited by 8 publications

(6 citation statements)

References 10 publications

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“…It seems to be more common in twin pregnancies. Previous reports showed a large abdominal wall defect and herniation of the liver, bowels, or heart into the exocoelom [12][13][14]. However, none of the cases showed conjoined intestine or fused skin bridge, in contrast to the present case.…”

Section: Discussioncontrasting

confidence: 80%

Three-dimensional ultrasonographic features of diamniotic conjoined twins with body stalk anomaly

Xiang

Wen

Zhang

et al. 2020

BMC Pregnancy Childbirth

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Background: Since conjoined twins were thought to be monoamniotic in the past, diamniotic conjoined twins would be improbable theoretically. Body stalk anomaly is a severe defect of the body wall, which is rare among twins. Body stalk anomaly in monochorionic diamniotic conjoined twins has never been reported prenatally so far as we know. Case presentation: Here we present an extremely rare case of concordant body stalk anomaly in monochorionic diamniotic conjoined twins. Ultrasonography at 9 + 5 weeks revealed one chorionic and two amniotic cavities, close apposition of abdomen, limited movement, and common umbilical vessels. Follow-up ultrasonography at 11 + 6 weeks and 13 + 2 weeks showed close apposition of the lower abdominal region with cystic structures and a small bowel-like mass between the two fetuses. Three-dimensional ultrasonography assisted in observing the entire appearance of both twins in earlier first trimester, including amnioticity, conjoined region and umbilical vessels. We attribute this diamniotic conjoined twin in our case to the fusion theory. A single yolk sac was observed, challenging the idea that yolk sac number predicts amnionicity. Identification of single yolk sac and its allantois may form a common body stalk during this fusion, leading to concordant body stalk anomaly in monochorionic diamniotic twins. Conclusions: Our case may provide important insights into both ultrasonographic features and embryogenesis of this extremely rare anomaly.

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Section: Discussioncontrasting

confidence: 80%

Three-dimensional ultrasonographic features of diamniotic conjoined twins with body stalk anomaly

Xiang

Wen

Zhang

et al. 2020

BMC Pregnancy Childbirth

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“…In our series, there were two cases of BSA in twin pregnancies. BSA has been reported to occur more frequently in both dizygotic [3,8] and monozygotic twins than in singleton pregnancies and that monozygotic twins can be concordant [9] or discordant for BSA [10,11,12]. Diagnosis of BSA in conjoined twins has not been reported before.…”

Section: Discussionmentioning

confidence: 95%

Ultrasound Features and Management of Body Stalk Anomaly

Panaitescu

Ushakov²,

Kalaskar³

et al. 2016

Fetal Diagn Ther

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Objectives: This study describes the prenatal diagnosis of body stalk anomaly (BSA) in a large series of affected pregnancies and proposes an algorithm for the differential diagnosis of abdominal wall defects in the first trimester. Methods: This was a retrospective study of all the cases of BSA diagnosed in our tertiary unit between 2009 and 2015. In all cases, we performed a detailed ultrasound examination with particular emphasis on the appearance of the amniotic membrane and content of the amniotic sac and the coelomic cavity. Results: The study included 17 cases of BSA (15 singleton pregnancies, one dichorionic-diamniotic twin pregnancy discordant for BSA and one case of conjoined twins) at a median gestational age of 12⁺³ (range 11⁺⁰ to 16⁺⁶) weeks. In all cases, the liver and bowel were herniated into the coelomic cavity and the amniotic sac was intact containing the rest of the fetus with a normal amount of amniotic fluid; additionally, there was severe kyphoscoliosis and positional abnormalities of the lower limbs. The umbilical cord was absent, but umbilical vessels were seen with color Doppler running from the placenta to the fetus marginally to the eviscerated abdominal content. Conclusion: BSA can be easily diagnosed from 11 weeks' gestation. Examination of the amniotic membrane continuity, content of both the amniotic sac and coelomic cavity and a short umbilical cord help in differentiating this condition from other abdominal wall defects.

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“…Baseline characteristics of the pregnancies are shown in Table . In four pregnancies, the mother requested termination of pregnancy: in three cases, as a result of fetal abnormalities (cystic hygroma in one twin; acrania in one twin, diaphragmatic hernia in the other twin; body stalk anomaly in both twins, this latter case has been described in detail elsewhere) and in one case for social reasons. In six other cases, the pregnancy miscarried spontaneously before 24 weeks of gestation.…”

Section: Resultsmentioning

confidence: 99%

The natural history of monoamniotic twin pregnancies: a case series and systematic review of the literature

et al. 2015

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Objective To describe the natural history of monoamniotic twin pregnancies in contemporary practice.Method Cohort study of monochorionic monoamniotic twin pregnancies with two live fetuses diagnosed at less than 16 weeks and prospectively followed up between 2004 and 2013. A systematic review of the literature using Medline, Embase and Scopus to determine the perinatal mortality rate after 24 weeks of gestation in monoamniotic twins was also performed.Results Twenty pregnancies were analyzed. Four were terminated (in three cases as a result of fetal abnormalities).Another six miscarried spontaneously. Among ten pregnancies reaching viability, there was double intrauterine death in one, and both fetuses were alive at delivery in the other nine. There were no neonatal deaths. Overall survival for fetuses alive at the initial scan was 18/40 (45%; 95% CI 29 to 62%). At meta-analysis of 13 studies (including the current series), the perinatal mortality rate after 24 weeks was 4.5% (95% CI 3.3 to 5.8%).Conclusions Despite early diagnosis and intensive monitoring, of those fetuses alive before 16 weeks less than half survive until the neonatal period. Most losses are attributable to fetal abnormalities and spontaneous miscarriage and are therefore unlikely to be reduced by further improvements in fetal assessment and monitoring.

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Concordant body stalk anomaly in a monoamniotic twin pregnancy at 9 weeks

Cited by 8 publications

References 10 publications

Three-dimensional ultrasonographic features of diamniotic conjoined twins with body stalk anomaly

Three-dimensional ultrasonographic features of diamniotic conjoined twins with body stalk anomaly

Ultrasound Features and Management of Body Stalk Anomaly

The natural history of monoamniotic twin pregnancies: a case series and systematic review of the literature

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