Journal
BMJ CASE REPORTS
Volume 14, Issue 5, Pages -Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/bcr-2021-242783
Keywords
limb body wall complex; dichorionic diamniotic twin pregnancy; abdominal wall defects; amniotic band syndrome; body stalk anomaly
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Limb body wall complex (LBWC) is a rare, lethal malformation characterized by body wall defects, craniofacial and limb anomalies. This case study reports a dichorionic diamniotic twin pregnancy discordant for LBWC, managed expectantly with a favorable outcome for the unaffected twin.
Limb body wall complex (LBWC) is a rare, lethal malformation characterised by body wall defects, craniofacial and limb anomalies with or without various other organ anomalies. We report a case of dichorionic diamniotic twin pregnancy discordant for LBWC, diagnosed by ultrasound (US) and confirmed by MRI at 21 weeks' gestation, managed expectantly and delivered at 35 weeks by emergency caesarean section with a favourable outcome of the unaffected twin. The anomalous twin, who died soon after birth, had a sizeable thoracoabdominal wall defect, eviscerated liver and bowel loops attached to the placenta, short cord, ectopia cordis, lung hypoplasia, kyphoscoliosis, right upper limb amelia and left clubfoot with polydactyly. MRI helps to demonstrate the fetal morphology better when there are limitations to the US due to unfavourable fetal position, multifetal gestation, maternal obesity or reduced liquor. In twin pregnancies, the management will depend on ensuring the survival of the unaffected twin.
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