Limb body wall complex complicating a dichorionic diamniotic twin pregnancy: MRI for demonstration of fetal morphology

Limb body wall complex (LBWC) is a rare, lethal malformation characterised by body wall defects, craniofacial and limb anomalies with or without various other organ anomalies. We report a case of dichorionic diamniotic twin pregnancy discordant for LBWC, diagnosed by ultrasound (US) and confirmed by...

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Bibliographic Details
Published in:BMJ case reports 2021-05, Vol.14 (5), p.e242783
Main Authors: Kashyap, Ravindar, Devaraj, Sunil Kumar, Chakkalakkoombil, Sunitha Vellathussery, Mohan, Supraja Laguduva
Format: Article
Language:English
Subjects:
Abdomen
Births
Bladder
Case Report
Case reports
Cesarean Section
Defects
Female
Fetus
Fetuses
Heart
Humans
Liver
Magnetic Resonance Imaging
Morphology
Placenta
Pregnancy
Pregnancy Reduction, Multifetal
Pregnancy, Twin
Stomach
Ultrasonic imaging
Umbilical cord
Uterus
Veins & arteries
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Summary:Limb body wall complex (LBWC) is a rare, lethal malformation characterised by body wall defects, craniofacial and limb anomalies with or without various other organ anomalies. We report a case of dichorionic diamniotic twin pregnancy discordant for LBWC, diagnosed by ultrasound (US) and confirmed by MRI at 21 weeks’ gestation, managed expectantly and delivered at 35 weeks by emergency caesarean section with a favourable outcome of the unaffected twin. The anomalous twin, who died soon after birth, had a sizeable thoracoabdominal wall defect, eviscerated liver and bowel loops attached to the placenta, short cord, ectopia cordis, lung hypoplasia, kyphoscoliosis, right upper limb amelia and left clubfoot with polydactyly. MRI helps to demonstrate the fetal morphology better when there are limitations to the US due to unfavourable fetal position, multifetal gestation, maternal obesity or reduced liquor. In twin pregnancies, the management will depend on ensuring the survival of the unaffected twin.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2021-242783