Twin pregnancy complicated with congenital Hemivertebra: report of two cases and literature review
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CASE REPORT
Open Access
Twin pregnancy complicated with congenital Hemivertebra: report of two cases and literature review Tingting Xu1,2, Xiaodong Wang1,2, Haiyan Yu1,2*
and Fumin Zhao1,2,3*
Abstract Background: Hemivertebra deformity, involving one or multiple vertebral bodies, is one of the important causes of congenital scoliosis. Congenital fetal hemivertebrae could be diagnosed by ultrasonography and confirmed by fetal magnetic resonance imaging during pregnancy. However, reports of hemivertebrae in twins during the perinatal period are very rare. Case presentation: We report two cases of congenital fetal hemivertebrae, each affecting one fetus in a dichorionic diamniotic (DCDA) twin pregnancy. We have also conducted a literature review of its prenatal screening, diagnosis, management, and outcomes. These two cases of congenital fetal hemivertebrae in one fetus of a DCDA twin were both initially found by ultrasonography and confirmed by fetal magnetic resonance imaging (MRI). One couple chose selective termination of the hemivertebrae fetus after they were extensively counseled by the multidisciplinary team regarding the treatment and prognosis of the hemivertebrae twin, and a healthy baby weighing 2320 g was delivered at the 37+ 1 gestational week. The other couple decided to continue the twin pregnancy and gave birth to two living newborns weighing 2580 g and 2060 g at 37+ 1 gestational weeks. These three babies were all in good health during follow-up. Conclusions: Based on our center’s experience, comprehensive ultrasonography is necessary for early prenatal diagnosis of this condition. In addition, fetal MRI will confirm the diagnosis of hemivertebrae and provide parents with helpful information for their decision about the fate of the affected fetus. Keywords: Fetal hemivertebrae, Dichorionic diamniotic twin pregnancy, Magnetic resonance imaging
Background Hemivertebra is a rare congenital vertebral abnormality that can lead to deformation of the spine, such as scoliosis, lordosis, or kyphosis [1], and it is usually located in the thoracic and lumbar regions. The birth rate of hemivertebrae is 0.05–0.10% [2], occurring more commonly in females. The sex ratios (male/female) for multiple vertebral anomalies and solitary vertebral anomalies are respectively 0.31 and 0.68 [3]. * Correspondence: [email protected]; [email protected] 1 Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China Full list of author information is available at the end of the article
The majority of published papers about hemivertebrae involve surviving newborns after birth, and few papers have focused on cases of congenital fetal hemivertebrae diagnosed during prenatal care. Most fetal hemivertebrae cases involve a singleton pregnancy, and cases of only one twin with hemivertebrae are very rare. Based on the published data of fetal hemivertebra in singletons we can see that fetal hemivertebra can be divided into isolated cases and coexisting anomalies. Most fetuses with pr
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