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CASE REPORT
Dichorionic twins discordant for body-stalk anomaly: a management challenge
  1. Rita Caldas1,
  2. Cátia Rodrigues2,
  3. Carla Pina2,
  4. Rosete Nogueira3,4
  1. 1Department of Obstetrics and Gynaecology, Centro Hospitalar de Entre o Douro e Vouga EPE, Porto, Portugal
  2. 2Department of Obstetrics and Gynaecology, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
  3. 3Department of Pathology, CGC Genetics Centro de Genetica Clinica, Porto, Portugal
  4. 4Department of Pathology, Life and Health Sciences Research Domain (ICVS), School of Medicine, University of Minho, Braga, Portugal
  1. Correspondence to Dr Rita Caldas, ritafcaldas{at}gmail.com

Summary

Body-stalk anomaly is a sporadic and rare maldevelopment disorder characterised by large abdominal wall defect, spinal deformity and rudimentary umbilical cord. It is considered a lethal condition as there are only few reports of survival but there was at least one case of long-term survival after neonatal surgery.

Differential diagnosis includes isolated omphalocele or gastroschisis, short umbilical cord, amniotic band, limb body-wall complex and other polymalformative syndromes.

There are few reports about the expectant prenatal management of the body stalk anomaly as the majority of prenatal diagnosed cases undergo early elective termination. Twin pregnancies discordant for the anomaly represent a challenge to prenatal management as a healthy fetus should also be considered.

We describe a case of dichorionic-diamniotic twins discordant for body stalk anomaly which underwent selective feticide of the affected fetus late in pregnancy, in accordance with parents’ decision focused on the neonatal well-being of the unaffected twin.

  • congenital disorders
  • materno-fetal medicine
  • pregnancy
  • medical management
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Footnotes

  • Contributors RC (first author): responsible for the conception, writing and design, data analysis, article draft and review. CR: responsible for the literature review and review of the article. CP: Doctor in charge of the clinical case (acquisition and analysis of data) and review of the text. RN: responsible for the pathological examination (acquisition and analysis of data), image formatting and final review of the text.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Local Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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