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DOI: 10.1055/s-2007-962942
© Georg Thieme Verlag KG Stuttgart · New York
Prenatal Ultrasound Assessment and Fetal Heart Monitoring: Analysis of Dizygotic Twins Discordant for Body Stalk Anomaly in the Third Trimester of Pregnancy
Pränatale Ultraschalldiagnostik dizygoter Zwillinge mit diskordanter Ausprägung einer Körperstammanomalie im dritten SchwangerschaftstrimesterPublikationsverlauf
received: 27.7.2005
accepted: 12.9.2006
Publikationsdatum:
21. Februar 2007 (online)
Zusammenfassung
Wir beschreiben den Fall einer dizygoten Zwillingsschwangerschaft, die unserem Zentrum aufgrund des sonografischen Befundes einer Diskordanzanomalie bei einem der beiden Zwillinge in der 32. Schwangerschaftswoche zugewiesen wurde. Der betroffene Fötus zeigte neben einer unspezifischen Mikromelie und einer schweren Kyphoskoliose eine Entwicklungsstörung des Enddarmes sowie eine stark verkürzte Nabelschnur. Des Weiteren fand sich ein Defekt der Abdominalwand mit extrakorporaler Lage von Leber und Darmanteilen. Diese Konstellation ist mit der Diagnose einer Body-Stalk-Anomalie, der Sequenz der fehlenden Nabelschnur, vereinbar. Nach unserer Kenntnis handelt es sich bei diesem Fall um einen der wenigen bisher publizierten Fälle einer Body-Stalk-Anomalie bei dizygoten Zwillingen mit diskordanter Ausprägung. Dieses Krankheitsbild kann, verbunden mit einer Verminderung des Fruchtwassers, pathogenetisch durch einen sehr frühen vorzeitigen Blasensprung bedingt sein.
Abstract
We describe a case of dizygotic twin pregnancy which was referred to our centre because of a discordant anomaly of one of the twins. The ultrasound examination revealed a large extra-abdominal mass (liver and bowel) with micromelia, severe kyphoscoliosis and a short umbilical cord of the second dizygotic discordant twin. These ultrasound findings were diagnosed as body stalk anomaly. Body stalk anomaly in twins is extremely rare. This is, to our knowledge, one of the few documented cases reported on dizygotic twins discordant for this anomaly. This finding, in association with a decrease of amniotic fluid volume, may be attributed to early amniotic membrane rupture as the primary event in the pathogenesis of body stalk anomaly.
Key words
prenatal diagnosis - ultrasound diagnosis - body stalk anomaly - limb body wall defect - dizygotic twins - fetal heart monitoring - third trimester
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