Twin pregnancy complicated with congenital Hemivertebra: report of two cases and literature review

Abstract

Background: Hemivertebra deformity, involving one or multiple vertebral bodies, is one of the important causes of congenital scoliosis. Congenital fetal hemivertebrae could be diagnosed by ultrasonography and confirmed by fetal magnetic resonance imaging during pregnancy. However, reports of hemivertebrae in twins during the perinatal period are very rare. Case presentation: We report two cases of congenital fetal hemivertebrae, each affecting one fetus in a dichorionic diamniotic (DCDA) twin pregnancy. We have also conducted a literature review of its prenatal screening, diagnosis, management, and outcomes. These two cases of congenital fetal hemivertebrae in one fetus of a DCDA twin were both initially found by ultrasonography and confirmed by fetal magnetic resonance imaging (MRI). One couple chose selective termination of the hemivertebrae fetus after they were extensively counseled by the multidisciplinary team regarding the treatment and prognosis of the hemivertebrae twin, and a healthy baby weighing 2320 g was delivered at the 37 + 1 gestational week. The other couple decided to continue the twin pregnancy and gave birth to two living newborns weighing 2580 g and 2060 g at 37 + 1 gestational weeks. These three babies were all in good health during follow-up. Conclusions: Based on our center's experience, comprehensive ultrasonography is necessary for early prenatal diagnosis of this condition. In addition, fetal MRI will confirm the diagnosis of hemivertebrae and provide parents with helpful information for their decision about the fate of the affected fetus.

Congenital kyphoscoliosis associated with thoracic hemivertebrae in a nine-month-old Racking filly

“…In humans, hemivertebra is a rare congenital anomaly and its incidence is estimated at 0.05%-0.1% and is more common in females (Shah et al, 2020;Varras & Akrivis, 2010;Xu et al, 2020). In animals, hemivertebra is the most common congenital malformation in dogs (De Rycke & Saunders, 2017;Ryan et al, 2017;Schlensker & Distl, 2016;Wyatt et al, 2018).…”

“…It has been demonstrated that Hemivertebra is one of the important causes of deviation from the normal curvature of the spine because the growth potential of the affected vertebrae is like the normal vertebrae (Yang et al, 2020). This condition can result in different structural deformities of the spinal axis including scoliosis, lordosis, and/or kyphosis (Xu et al, 2020). Structural abnormalities may affect the spinal cord so, a neurological examination should be considered to determine the neurological signs (Kaplan, Spivak, & Bendo, 2005).…”

Congenital kyphoscoliosis associated with thoracic hemivertebrae in a 9‐month‐old Racking filly

“…In humans, hemivertebra is a rare congenital malformation, and its incidence is estimated at 0.05%–0.1% and is more common in females (Shah et al, 2020; Varras & Akrivis, 2010; Xu et al, 2020). In animals, hemivertebra is the most common congenital malformation in dogs (De Rycke & Saunders, 2017; Ryan et al, 2017; Schlensker & Distl, 2016; Wyatt et al, 2018).…”