Triploidy in a Growth Discordant Twin Pregnancy after Intracytoplasmic Sperm Injection Treatment

Abstract

Objective: We report on a case of a triploidy in one fetus of a twin pregnancy who presented with the findings of growth discordance. Methods: Three weeks’ difference between fetuses in ultrasonographic measurements in the first trimester was observed in a twin pregnancy following intracytoplasmic sperm injection (ICSI) treatment for male infertility. Hydrocephaly developed in the growth-discordant fetus subsequently. Amniocentesis for both fetuses and selective feticide for the abnormal one was performed at 19weeks’ gestation through a single insertion. Fetal karyotype of the abnormal one was 69,XXX and the healthy one was 46,XX. Conclusion: Early developed growth discordance in a twin pregnancy may be a sign of chromosomal abnormality such as triploidy. Those cases should be karyotyped without delay to decrease preterm delivery risk of possible selective feticide.

Twin pregnancy with triploidy and co-existing live twin progressing to viability: Case study and literature review

“…If a live fetus is present, chorionic villous sampling (CVS) or amniocentesis can be performed to confirm the diagnosis and offer selective termination of the triploid twin to ensure the best possible outcome for the healthy twin. 8 Some of the maternal complications associated with twin pregnancies with a triploid fetus and healthy co-twin include per vaginal bleeding or haemorrhage, hypertensive disorders of pregnancy, hyperemesis, thyrotoxicosis, pulmonary oedema and thromboembolic phenomena. The risks to the fetus when pregnancy continues include miscarriage, intrauterine fetal demise, preterm labour, malpresentation and fetal growth restriction.…”

Transient early preeclampsia in twin pregnancy with a triploid fetus: a case report

“…Two cases of successful outcome for the normal co-twin in a triploid twin pregnancy have been reported [7,8]. In both cases, selective abortion of the triploid fetus was performed.…”

“…Experiences with partial molar twin pregnancies are limited. Only five cases of a triploid fetus and a healthy co-twin have been reported [4]-[8]. Of these five cases, two co-twins survived after selective abortion of the triploid fetus.…”

“…There are only two cases reported with survival of the healthy co-twin, both after selective abortion of the triploid fetus. One healthy co-twin was born after 27 weeks' gestation and the other after 38 weeks' gestation [7,8]. …”