Monoamniotic Twins with One Fetal Anencephaly and Cord Entanglement Diagnosed with Three Dimensional Ultrasound at 14 Weeks of Gestation

Jo, Yun Sung; Son, Hyun Joo; Jang, Dong Gyu; Kim, Narinay; Lee, Guisera

doi:10.7150/ijms.8.573

Cited by 3 publications

(4 citation statements)

References 14 publications

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“…Although a short series with SF did not find a reduction in the rate of early preterm delivery [6], a recent systematic review with 58 dichorionic twin pregnancies discordant for anencephaly concluded that while SF does not reduce perinatal mortality, it does result in significantly longer gestations and higher birth weight than expectant management, as observed when compared to the two present cases [9].…”

Section: Discussioncontrasting

confidence: 52%

“…In these cases, polyhydramnios is caused by an impairment of the swallowing reflex of the anencephalic fetus and the management in severe cases may include amniodrainage or late SF. Invasive management in late pregnancy has potential complications, such as rupture of membranes, chorioamnionitis or fetal death [6,8,9]. Vandercruys et al observed, in a group of 35 dichorionic twin pregnancies discordant for anencephaly with expectant management, an incidence of 55% of polyhydramnios between 25 and 31 weeks gestation, requiring invasive procedures in 35% of them, which represents 20% of the total [6].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Dichorionic twin pregnancy discordant for anencephaly: two cases with different management

M¹,

Arrieta²,

Herrero³

et al. 2014

Clin. Exp. Obstet. Gynecol.

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Background: Prevalence of anencephaly in dichorionic twins is higher than in singleton pregnancies. The authors report two cases with two different management strategies. Case 1: Spontaneous dichorionic diamniotic twin pregnancy with the second twin diagnosed with anencephaly at 12 weeks gestation. Selective feticide was performed at the age of 13.2 weeks. Vaginal delivery occurred at 39 weeks, and birth weight was 2,850 g. Case 2: Dichorionic diamniotic twin pregnancy discordant for anencephaly in the second twin was diagnosed at 13 weeks gestation. An expectant management was decided. Preterm delivery occurred at 35 weeks due to hydramnios of the affected fetus, delivering a healthy newborn weighing 2,300 g and an anencephalic neonate who died immediately after delivery. Conclusion: Anencephaly should be diagnosed as soon as possible, idealistically at 11-13+6 weeks ultrasound (US) scan, in order to offer the most appropriate counselling to the parents, ranging from selective feticide or expectant management. This short series suggests that selective early feticide may increase gestational age and birth weight.

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Section: Discussioncontrasting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Dichorionic twin pregnancy discordant for anencephaly: two cases with different management

M¹,

Arrieta²,

Herrero³

et al. 2014

Clin. Exp. Obstet. Gynecol.

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“…Paraplegia is present in 25%, severe paraparesis in 25%, and about 25% of children with no significant extremity dysfunction [13]. If a previous pregnancy was complicated with spina bifida, the risk of its recurrence is ten times higher [6,14,15]. The present survey included two (13%) fetuses with myelomeningocele and four (17%) with meningocele.…”

Section: Discussionmentioning

confidence: 98%

The outcome and course of pregnancies complicated with fetal neural tube defects

Steric¹,

Stamenkovic²,

Srbinović³

et al. 2015

Clin. Exp. Obstet. Gynecol.

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Purpose: The objectives of this study were as follows: to present the course and outcome of pregnancies complicated with neural tube defects, determine the association between prenatal ultrasound diagnoses, and definitive diagnoses after autopsy. Matherial and Methods: The survey was designed as a retrospective study and included 24 pregnant women who were attending a regular ultrasound examinations at the Department of Gynecology and Obstetrics, Clinical Center of Serbia, or patients who were referred from other institutions in Serbia. Results: Neural tube defects are divided into five subgroups: spina bifida, meningocele, myelomeningocele, acranius, and anencephaly. The most frequent in the present study was spina bifida with 67%. All pregnancies complicated with neural tube defects were terminated. Conclusion: Their clinical severity and uncertain cause make them priorities for further research, whether to better target primary preventive measures, to improve in-utero surgery for prenatal repair, or to identify the causative genes to provide an objective basis for individual genetic counselling.

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“…It is common for monozygous twins to have identical phenotypes, yet some twins have significant discordant features [Hall, ; Chambers et al, ; Zwijnenburg et al, ]. Increasingly, fetal imaging detects a malformation in only one twin [Jo et al, ; Harper et al, ; Ramsey et al, ]. In such instances, the question of true zygosity of the twins is sometimes reexamined.…”

Section: Introductionmentioning

confidence: 99%

Monoamniotic monochorionic twins discordant for noncompaction cardiomyopathy

Bouhlal

Ursell

et al. 2013

American J of Med Genetics Pt A

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Occasionally “identical twins” are phenotypically different, raising the question of zygosity and the issue of genetic versus environmental influences during development. We recently noted monochorionic-monoamniotic twins, one of which had an isolated cardiac abnormality, noncompaction cardiomyopathy, a condition characterized by cardiac ventricular hypertrabeculation. We examined the prenatal course and subsequent pathologic correlation since ventricular morphogenesis may depend on early muscular contraction and blood flow. The monochorionic-monoamniotic female twin pair was initially identified since one fetus presented with increased nuchal translucency. Complete heart block was later identified in the fetus with nuchal translucency who did not survive after delivery. In contrast, the unaffected twin had normal cardiac studies both prenatally and postnatally. Pathologic analysis of the affected twin demonstrated noncompaction of the left ventricle with dysplasia of the aortic and pulmonary valves. Dissection of the cardiac conduction system disclosed atrioventricular bundle fibrosis. Maternal lupus studies, amniocentesis with karyotype, and studies for 22q11.2 were normal. To test for zygosity, we performed multiple STR marker analysis and found that all markers were shared even using non-blood tissues from the affected twin. These studies demonstrate that monozygotic twins that are monochorionic monoamniotic can be discordant for cardiac noncompaction. The results suggest further investigation into the potential roles of pathologic fibrosis, contractility, and blood flow in cardiac ventricle development.

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Monoamniotic Twins with One Fetal Anencephaly and Cord Entanglement Diagnosed with Three Dimensional Ultrasound at 14 Weeks of Gestation

Cited by 3 publications

References 14 publications

Dichorionic twin pregnancy discordant for anencephaly: two cases with different management

Dichorionic twin pregnancy discordant for anencephaly: two cases with different management

The outcome and course of pregnancies complicated with fetal neural tube defects

Monoamniotic monochorionic twins discordant for noncompaction cardiomyopathy

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