Second trimester selective termination in a dizygotic twin pregnancy with discordancy for Arnold-Chiari malformation: A case report.

Lee, Sang Hun; Park, Sung Ho; Park, Ki Han; Cho, Hyun Jin; Chung, Tea Bum; Jun, Hyun Ah; Lee, Keun Young

Case Report

Korean Journal of Obstetrics & Gynecology 2001;44(11):2117-2121.
Published online November 1, 2001.

Second trimester selective termination in a dizygotic twin pregnancy with discordancy for Arnold-Chiari malformation: A case report.

Sang Hun Lee, Sung Ho Park, Ki Han Park, Hyun Jin Cho, Tea Bum Chung, Hyun Ah Jun, Keun Young Lee

Department of Obstetrics and Gynecology, College of Medicine, Hallym University, Seoul, Korea.

Abstract

A 38-year-old woman with twin pregnancy was referred after detection of hydrocephalus in one fetus at 23+1 weeks' gestation. Sonography showed hydrocephalus, a scalloping of the frontal bone giving a lemon-like configuration, and meningocele. The affected twin was terminated by ultrasonographically guided intracardiac injection of 4 ml (8 mEq/L) potassium chloride solution at 24+5 weeks' gestation. Chromosomal analysis of the other fetus showed normal findings (46, XX). Serial ultrasound scans and coagulopathy tests were unremarkable. Preterm premature rupture of the membrane was developed at 33+3 weeks' gestation, and emergency Cesarian section was done. A healthy 1360 g female was born, with Apgar scores of 7 and 8 at one and five minutes, respectively.

Key Words: Selective termination, Arnold-Chiari Malformation, Twin pregnancy