Monozygotic twins discordant for single umbilical artery and congenital heart disease,☆☆,

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Abstract

We report a case of monozygotic twins. One twin had a single umbilical artery and the other co-twin had congenital heart disease. This case and a review of the literature suggest that local environmental factors are important in the pathogenesis of these malformations although genetic factors cannot be excluded.

Section snippets

Case report

A 25-year-old woman, gravida 2, para 0, was seen at 6 weeks’ gestation for her first prenatal visit. She had Hashimoto’s disease that was managed with levothyroxine at that stage and became euthyroid during the rest of pregnancy. Transvaginal ultrasonography at 10 weeks’ gestation showed a gestational sac containing 2 fetuses (2.5 cm and 2.5 cm in crown-rump length) separated by very thin membranes. She was admitted to our hospital at 26 weeks’ gestation after the detection of a small amount of

Comment

Because monozygotic twins arise from a single fertilized ovum that subsequently divides into two similar structures, monozygotic twins are presumed to be genetically identical, and they usually have similar characteristics. However, monozygotic twins are not always concordant for congenital malformations. As for congenital heart disease and single umbilical artery, both concordant and discordant cases of monozygotic twins have been described, suggesting that not all cases share the same cause.

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From the Department of Obstetrics and Gynecology, Nagasaki University, School of Medicine.

☆☆

Reprint requests: Daisuke Nakayama, MD, Department of Obstetrics and Gynecology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852, Japan.

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