Discordant anencephaly and Cantrell syndrome in monozygotic twins conceived by ICSI and IVF-ET

摘要

A 35-year-old primigravid woman presented with a twin pregnancy at 13 weeks of gestation for evaluation of structural abnormalities in one co-twin. The woman and her husband were healthy and non-consanguineous. The husband was aged 37 years. There was no family history of congenital malformations. The woman did not have diabetes mellitus and denied any recent infections or exposure to teratogens during this pregnancy. The woman had suffered from primary infertility. This was her first pregnancy and it was achieved by intra-cytoplasmic sperm injection (ICSI), in vitro fertilization (IVF) and embryo transfer (ET). Two embryos had been implanted and a twin pregnancy was achieved. Prenatal ultrasound at 13 weeks of gestation revealed a dichorionic, diamniotic twin pregnancy with a normal co-twin and an abnormal co-twin with anencephaly and eviscerated heart, stomach, liver, and intestines. The pregnancy was uneventful until 16 weeks of gestation when uncontrolled preterm labor occurred. A 45-g normal male co-twin and a 30-g abnormal male co-twin with anencephaly and anterior abdominal wall defects with ectopia cordis and eviscerated stomach, liver, and intestines, a sternal detect, and a defect in the diaphragm were delivered (Figs. 1 and 2).