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Triplet pregnancy with acardius acranius after preimplantation diagnosis
R L Schild1, H Plath, H J Födisch
1Department of Fetal Diagnosis and Therapy, University Hospital, Bonn, Germany. rlschild@mailer.meb.uni-bonn.de
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.
