Monozygotic twin aborted fetuses discordant for holoprosencephaly/synotia

A pair of monozygotic twin fetuses aborted at 15 weeks were found to be discordant for holoprosencephaly and synotia. They were studied grossly, radiologically, and histologically. Features of first brancial arch dysplasia (synotia, agnathia, and astomia) and holoprosencephaly (absent ethmoid bone and Rathke's pouch) observed in one twin were contrasted with minimal dysmorphology in the co-twin. Some evidence of the twin transfusion syndrome was also apparent, perhaps contributing to the twins' spontaneous abortion.