Twin pregnancy complicated with congenital Hemivertebra
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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.

A 32-year-old pregnant woman, gravida 3, para 0, underwent in vitro fertilization and embryo transfer, and 2 embryos were transferred to the uterus. After the embryo transfer, ultrasonography revealed a DCDA twin pregnancy. The regular prenatal ultrasonography at 25+3 gestational weeks identified that the T12 vertebral body of the spine was slightly abnormal in one twin without any other structural abnormalities including musculoskeletal, genitourinary, cardiac, etc., while the co-twin was normal. Fetal MRI of the twin was performed and the diagnosis of fetal hemivertebrae was made for this affected fetus. The co-twin was normal. The chromosomal microarray analysis of the amniotic fluid sample in both twins was normal. The couple decided to continue the pregnancy after extensive counseling by the multidisciplinary team.

A cesarean section was conducted at 37+1 gestational weeks for a fetal breech presentation, and two living male babies were delivered. The birth weights of these two newborns were 2580g and 2060g with Apgar scores of 10 and 10 at 1 and 5min, respectively. Finally, they chose postnatal documentation of the hemivertebrae in the second twin by the postnatal US. Doctors found the T12 level hemivertebrae and no other structural abnormalities. The twins were in good health for more than 1 year of follow-up. The baby with hemivertebrae was assessed for associated skeletal, cardiac, renal, and gastrointestinal anomalies after birth and showed no progression of scoliosis. He is being followed by the Child Healthcare Department and Orthopedics Department.