medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2013, Number 03

<< Back Next >>

Ginecol Obstet Mex 2013; 81 (03)

Twin pregnancy discordant for trisomy 13: three cases

López-Velasco N, Sotillo-Mallo L, Martínez-Montoro B, Fernández-Miranda M

Language: Spanish
References: 19
Page: 158-162
PDF size: 1148.17 Kb.


ABSTRACT

Background: The association between Patau’s syndrome and multiple pregnancy is extremely rare. This paper reports three cases with different obstetric treatment.
Case 1: Dichorionic diamniotic twin pregnancy with a fetus affected by trisomy 13 diagnosed at 16 weeks of gestation. The pregnancy was managed conservatively resulting in the delivery of twins at 38 weeks. The structurally normal twin was male survived without sequelae, but the female fetus with trisomy 13 died shortly after delivery.
Case 2: Dichorionic diamniotic twin pregnancy. At 14 weeks of pregnancy, one of the fetus affected by trisomy 13 showed an early intrauterine growth restriction and a cystic hygroma. At 16 weeks of pregnancy the abnormal twin died spontaneously. A vaginal delivery occurred at 38 weeks being born a healthy male.
Case 3: Dichorionic diamniotic twin pregnancy. The trisomy 13 fetus had been diagnosed at 17 weeks of pregnancy and showed a cardiopathy. At 32 weeks of gestation a selective fetal reduction was performed. Vaginal delivery occurred at 35 weeks and a healthy newborn was born.
Conclusion: Patau’s syndrome has an unfortunate fetal and neonatal outcome. It is important an early diagnosis to establish the best strategy to minimize the risk of the healthy twin.


REFERENCES

  1. Massiah N, Griffiths E, Bamigboye V. Twin trisomies- Edward and Patau syndromes. Fertil Steril 2008;90:e23-e24.

  2. Patau K, Smith DW, Therman E. Multiple congenital anomaly caused by an extra autosome. Lancet 1960;1:790.

  3. Morris JK, Savva GM. The risk of fetal loss following a prenatal diagnosis of trisomy 13 or trisomy 18. Am J Med Genet 2008;146(A):827-832.

  4. Naylor C, Tewari K, Asrat T. Trisomy 13 in one fetus from a twin gestation after Intracytoplasmic sperm injection: a case report. J Reprod Med 2001;46:497-498.

  5. Sepulveda W, Wong A, Ocaranza M. Heterokaryotypic pregnancy: monozygotic monochorionic twins discordant for trisomy 13. Fetal Diagn Ther 2010;28:109-113.

  6. Ramsey KW, Slavin TP, Grahan G, Hirata GI, et al. Monozigotic twins discordant for trisomy 13. J Perinatol 2012;32:306-308.

  7. Taylor D M, Thum M Y, Abdalla H. Dichorionic triamniotic triplet pregnancy with monozygotic twins discordant for trisomy 13 after preimplantation genetic screening: case report. Fertil Steril 2008;90:2017.e5-e9.

  8. Hernandez R, Ochoa M, Flores R, Cortés R, Forsbasch G. Prevalencia de embarazos múltiples: incremento en la última década. Ginecol Obstet Mex 2008;76: 507-511.

  9. De la Calle M, Cruceyra M, Rodriguez R, Magdaleno F y col. Gestación gemelar con muerte intraútero de uno de los fetos: pronóstico materno y neonatal del feto superviviente. Ginecol Obstet Mex 2012;80:254-262.

  10. Montoya B, Muñoz R, Rivera C, López B, et al. Adverse perinatal outcomes in Mexican women with twin pregnancy achieved by assisted reproduction techniques vs. spontaneous twin pregnancies. Ginecol Obstet Mex 2012;80:445-453.

  11. Mayor S. Risk of congenital malformations in children born after assisted reproduction is higher than previously thought. BMJ 2010;340:c3191.

  12. Wald N, Simon R. Prenatal screening for Down syndrome and neural tube defects in twin pregnancies. Prenat Diag 2005;25:740-745.

  13. Linskens H. Early first-trimester free B-HCG and PAPP-A serum distributions in monochorionic and dichorionic twins. Prenat Diagn 2009;29:74-78.

  14. Hui PW, Tang MH, Ng EH, Yeung WS, Ho PC. Nuchal tanslucency in dichorionic twins conceived after assisted reproduction. Prenatal Diagn 2006;26:510-513.

  15. Wright D, Syngelaki A, Staboulidou I, Cruz JJ, Nicolaides KH. Screening for trisomies in dichorionic twins by measurement of fetal nuchal translucency thickness according to the mixture model. Prenatal Diagn 2011;31:16-21.

  16. Chasen S, Perni S, Kalish R, Chervenak F. First-trimester risk assessment for Trisomies 21 and 18 in twin pregnancy. AJOG 2007;197:374.e1-374.e3.

  17. Sebire NJ, Snijders RJ, Santiago C, Papapanagiotou G, Nicolaides KH. Management of twin pregnancies with fetal trisomies. J Obstet Gynaecol 1997;104:220-222.

  18. Eddleman KA, Stone JL, Lynch L, Berkowitz RL. Selective termination of anomalous fetuses in multifetal pregnancies: two hundred cases at a single center. Am J Obstet Gynecol 2002;187:1168-1172.

  19. Antolin E, Pérez R, Gámez F, de León J, et al. Selective termination in dichorionic twins discordant for congenital defect. Eur J Obstet Gynecol Reprod Biol 2012;161:8-11.




2020     |     www.medigraphic.com