Clinical dysmorphology · 2026
Monochorionic dizygotic twins with discordant genetic findings and congenital malformations.
СтатьяНазвание и аннотация: Перевод в очереди
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Luo Caiqun, Wu Xiaoxia, Liu Yang, Feng Qing, Chen Liyuan, Wang Hui
Аннотация
OBJECTIVE: To describe prenatal evaluation and postnatal outcome of monochorionic diamniotic twins with discordant anomalies and genetic findings after intracytoplasmic sperm injection and double-embryo transfer.
METHODS: A 36-year-old gravida 3 para 0 woman conceived after transfer of two blastocysts. Ultrasound identified monochorionic diamniotic twins and a liver-containing omphalocele in fetus B. Both sacs underwent separate amniocentesis. Testing included karyotyping, chromosome microarray, Beckwith-Wiedemann syndrome analysis, trio whole-exome sequencing, short tandem repeat analysis, postnatal peripheral blood fluorescence in situ hybridization, and placental histopathology.
RESULTS: Fetus A had mosaic 45,X[9]/46,XY[91]; fetus B had a 46,XY karyotype. Other prenatal genetic tests were unremarkable. Discordance at 11 of 21 short tandem repeat loci supported dizygosity. Following prelabor rupture of membranes at 34 + 5 weeks, two male infants were delivered by cesarean section. Twin A had hypospadias and bilateral cryptorchidism; twin B had giant omphalocele requiring surgical repair. Postnatal fluorescence in situ hybridization detected no sex-chromosome mosaicism. Placental histopathology confirmed monochorionicity.
CONCLUSION: Monochorionicity does not exclude dizygosity after assisted reproduction. Separate sampling of both sacs may inform discordant cases, and prenatal-postnatal discrepancies in 45,X/46,XY mosaicism warrant cautious longitudinal interpretation.
METHODS: A 36-year-old gravida 3 para 0 woman conceived after transfer of two blastocysts. Ultrasound identified monochorionic diamniotic twins and a liver-containing omphalocele in fetus B. Both sacs underwent separate amniocentesis. Testing included karyotyping, chromosome microarray, Beckwith-Wiedemann syndrome analysis, trio whole-exome sequencing, short tandem repeat analysis, postnatal peripheral blood fluorescence in situ hybridization, and placental histopathology.
RESULTS: Fetus A had mosaic 45,X[9]/46,XY[91]; fetus B had a 46,XY karyotype. Other prenatal genetic tests were unremarkable. Discordance at 11 of 21 short tandem repeat loci supported dizygosity. Following prelabor rupture of membranes at 34 + 5 weeks, two male infants were delivered by cesarean section. Twin A had hypospadias and bilateral cryptorchidism; twin B had giant omphalocele requiring surgical repair. Postnatal fluorescence in situ hybridization detected no sex-chromosome mosaicism. Placental histopathology confirmed monochorionicity.
CONCLUSION: Monochorionicity does not exclude dizygosity after assisted reproduction. Separate sampling of both sacs may inform discordant cases, and prenatal-postnatal discrepancies in 45,X/46,XY mosaicism warrant cautious longitudinal interpretation.