Monoamniotic twins discordant for body stalk anomaly

Tavares, Mariana Vide; Domingues, Ana Patrícia; Tavares, Margarida; Fonseca, Etelvina; Moura, Paulo

doi:10.3109/14767058.2014.900035

Cited by 8 publications

(7 citation statements)

References 7 publications

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“…It seems to be more common in twin pregnancies. Previous reports showed a large abdominal wall defect and herniation of the liver, bowels, or heart into the exocoelom [12][13][14]. However, none of the cases showed conjoined intestine or fused skin bridge, in contrast to the present case.…”

Section: Discussioncontrasting

confidence: 82%

Three-dimensional ultrasonographic features of diamniotic conjoined twins with body stalk anomaly

Xiang

Wen

Zhang

et al. 2020

BMC Pregnancy Childbirth

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Background: Since conjoined twins were thought to be monoamniotic in the past, diamniotic conjoined twins would be improbable theoretically. Body stalk anomaly is a severe defect of the body wall, which is rare among twins. Body stalk anomaly in monochorionic diamniotic conjoined twins has never been reported prenatally so far as we know. Case presentation: Here we present an extremely rare case of concordant body stalk anomaly in monochorionic diamniotic conjoined twins. Ultrasonography at 9 + 5 weeks revealed one chorionic and two amniotic cavities, close apposition of abdomen, limited movement, and common umbilical vessels. Follow-up ultrasonography at 11 + 6 weeks and 13 + 2 weeks showed close apposition of the lower abdominal region with cystic structures and a small bowel-like mass between the two fetuses. Three-dimensional ultrasonography assisted in observing the entire appearance of both twins in earlier first trimester, including amnioticity, conjoined region and umbilical vessels. We attribute this diamniotic conjoined twin in our case to the fusion theory. A single yolk sac was observed, challenging the idea that yolk sac number predicts amnionicity. Identification of single yolk sac and its allantois may form a common body stalk during this fusion, leading to concordant body stalk anomaly in monochorionic diamniotic twins. Conclusions: Our case may provide important insights into both ultrasonographic features and embryogenesis of this extremely rare anomaly.

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Section: Discussioncontrasting

confidence: 82%

Three-dimensional ultrasonographic features of diamniotic conjoined twins with body stalk anomaly

Xiang

Wen

Zhang

et al. 2020

BMC Pregnancy Childbirth

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“…In our series, there were two cases of BSA in twin pregnancies. BSA has been reported to occur more frequently in both dizygotic [3,8] and monozygotic twins than in singleton pregnancies and that monozygotic twins can be concordant [9] or discordant for BSA [10,11,12]. Diagnosis of BSA in conjoined twins has not been reported before.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Features and Management of Body Stalk Anomaly

Panaitescu

Ushakov²,

Kalaskar³

et al. 2016

Fetal Diagn Ther

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Objectives: This study describes the prenatal diagnosis of body stalk anomaly (BSA) in a large series of affected pregnancies and proposes an algorithm for the differential diagnosis of abdominal wall defects in the first trimester. Methods: This was a retrospective study of all the cases of BSA diagnosed in our tertiary unit between 2009 and 2015. In all cases, we performed a detailed ultrasound examination with particular emphasis on the appearance of the amniotic membrane and content of the amniotic sac and the coelomic cavity. Results: The study included 17 cases of BSA (15 singleton pregnancies, one dichorionic-diamniotic twin pregnancy discordant for BSA and one case of conjoined twins) at a median gestational age of 12⁺³ (range 11⁺⁰ to 16⁺⁶) weeks. In all cases, the liver and bowel were herniated into the coelomic cavity and the amniotic sac was intact containing the rest of the fetus with a normal amount of amniotic fluid; additionally, there was severe kyphoscoliosis and positional abnormalities of the lower limbs. The umbilical cord was absent, but umbilical vessels were seen with color Doppler running from the placenta to the fetus marginally to the eviscerated abdominal content. Conclusion: BSA can be easily diagnosed from 11 weeks' gestation. Examination of the amniotic membrane continuity, content of both the amniotic sac and coelomic cavity and a short umbilical cord help in differentiating this condition from other abdominal wall defects.

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“…In monochorionic pregnancies, the twins can be either concordant or discordant for the anomaly, regardless of amnionicity, and significant anatomic details visible on ultrasound are only described in the most recent cases. A further case of monoamniotic fetuses discordant for the anomaly and diagnosed at 11 weeks of gestation was very recently reported: the affected fetus presented with a large anterior abdominal wall defect, scoliosis, absent lower limbs, short umbilical cord, and increased nuchal translucency.…”

mentioning

confidence: 98%

Concordant body stalk anomaly in a monoamniotic twin pregnancy at 9 weeks

2014

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What's already known about this topic? Cases of early pregnancy diagnosis of body stalk anomaly are relatively few, particularly in twins. What does this study add? This is the first diagnosis of concordant body stalk anomaly in monoamniotic twins before 10 gestational weeks. The observation of an intact amniotic cavity with both embryos showing the same anomaly supports a primary ectodermal failure as the cause for body stalk anomaly.

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Monoamniotic twins discordant for body stalk anomaly

Cited by 8 publications

References 7 publications

Three-dimensional ultrasonographic features of diamniotic conjoined twins with body stalk anomaly

Three-dimensional ultrasonographic features of diamniotic conjoined twins with body stalk anomaly

Ultrasound Features and Management of Body Stalk Anomaly

Concordant body stalk anomaly in a monoamniotic twin pregnancy at 9 weeks

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