Confined blood chimerism in a monochorionic dizygotic sex discordant twin pregnancy conceived after induced ovulation
Confined blood chimerism in a monochorionic dizygotic sex discordant twin pregnancy conceived after induced ovulation
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DOI：
10.1002/bdra.23457
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发表时间：
2016-04-01
影响因子：
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通讯作者：
Brisset, Sophie
中科院分区：
文献类型：
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作者：
Le Bras, Anne Mayeur;Petit, Francois;Brisset, Sophie
背景单绒毛膜双胞胎通常被认为是同卵双胞胎妊娠。然而，也有几例单卵异卵双胎妊娠的报道。病例报告：我们报告一例罕见的单绒毛膜异卵双胎妊娠后，诱导排卵在一个32岁的妇女。妊娠18+4周形态超声检查诊断，两胎性别不一致。病人拒绝了羊膜穿刺术。结果胎盘组织病理学检查证实为单绒毛膜状态。在分娩时，观察到一个表型正常的男孩和一个表型正常的女孩，没有性异常。该分析还揭示了两个胎儿循环之间存在血管吻合。出生后细胞遗传学分析表明外周血淋巴细胞存在嵌合。这种嵌合现象在口腔拭子细胞中未观察到。分子合性测定证实了与亲本等位基因存在的限制性外周血嵌合。结论报告1例单绒毛膜异卵双胎妊娠。这一观察结果表明，需要仔细评估双胎妊娠，特别是在辅助生殖技术后获得的双胎妊娠。出生缺陷研究（分册），2016。(c) 2016 Wiley Periodicals, Inc.；
BackgroundMonochorionic twins are generally considered as a monozygotic twin pregnancy. However, several cases of monochorial dizygotic twin pregnancies have been reported. Case Report: We report on a rare case of monochorionic dizygotic twin pregnancy conceived after induced ovulation in a 32-year-old woman. The diagnosis was made on morphological ultrasound examination at 18+4 weeks of gestation, showing two fetuses with discordant sex. The amniocentesis was declined by the patient.ResultsThe monochorionic status was confirmed after a histopathalogical study of the placenta. At delivery, both a phenotypically normal boy and a phenotypically normal girl without sexual abnormality were observed. This analysis also revealed the presence of vascular anastomoses between both fetal circulations. Postnatal cytogenetic analyses indicated the presence of a chimerism in peripheral blood lymphocytes. This chimerism was not observed in cells obtained from a buccal swab. Molecular determination of zygosity confirmed the existence of the confined peripheral blood chimerism with the presence of four parental alleles.ConclusionWe report on a case of monochorionic dizygotic twin pregnancy. This observation underlies the need to carefully assess twin pregnancies, especially when obtained after assisted reproductive technology. Birth Defects Research (Part A) 106:298-303, 2016. (c) 2016 Wiley Periodicals, Inc.