Triplet pregnancy with acardius acranius after preimplantation diagnosis.

OBJECTIVE

To report the first case of fetal malformation after preimplantation diagnosis for Duchenne muscular dystrophy (DMD).

DESIGN

Case report.

SETTING

Perinatal center in a university hospital.

PATIENT(S): A conductor for DMD in her third pregnancy.

INTERVENTION(S): Preimplantation diagnosis was performed in an outside hospital. In our center, a dichorionic triplet pregnancy with acardius acranius was diagnosed. The anastomosis between the "pump"-twin and the fetus with acardius was embolized with histoacryl to prevent worsening cardiac insufficiency of the "pump"-twin.

MAIN OUTCOME MEASURE(S): Pregnancy outcome.

RESULT(S): The anastomosis between the "pump"-twin and the fetus with acardius was occluded successfully. Premature preterm rupture of membranes led to rapid labor and delivery at 24 + 5 weeks' gestation. The smaller girl died of severe hyaline membrane disease, whereas the other infant had no major clinical problems and has developed well.

CONCLUSION(S): There might be an association between embryo biopsy and fetal malformations. The setting up of a birth register after embryo biopsy is strongly recommended.