Recognition of a twin pregnancy in a balanced translocation carrier constituted the basis for referral for prenatal diagnosis. She and her husband were 25 years old, phenotypically normal, and not consanguineous.Their first pregnancy had produced a stillborn female with a multiple congenital anomalies (MCA) syndrome at 35 weeks of gestation. The fetus weighed 1,790 g, and measured 43 cm from crown to heel, 29.3 cm from crown to rump, and 29.1 cm in occipitofrontal circumference (OFC). The placenta weighed 380 g with the fetal surface showing the normal vascular pattern and the cord containing the usual three vessels. The anomalies included 1) anophthalmia, with absent optic nerves and lateral geniculate bodies; 2) absent olfactory bulbs and striae; 3) unilaterally open temporal lobe operculum; 4) "fused pluricystic, hypoplastic kidneys," which weighed 9 g (normal = 16 g); 5 ) hypoplastic lungs, weighing 16 g (normal = 38 g); 6) kypho-