Twin pregnancy with gastroschisis in both twins.
OBJECTIVE
Gastroschisis is a congenital malformation characterized by an abdominal wall defect located laterally to a normal umbilicus. The cause of gastroschisis is unknown, but most authors consider it exogenous. We describe the case of a woman with a twin pregnancy in which both twins had gastroschisis.


METHODS
A 17-year-old primiparous female was referred to our institution because of a twin pregnancy, with one twin diagnosed with gastroschisis at 34 weeks of gestation. Unfortunately, gastroschisis was noted in both twins, but no other anomalies were observed under level II sonographic evaluation. The twins were delivered by cesarean section at 36+ weeks of gestation because of preterm labor and breech presentation of one fetus. Both twins presented with a 3-cm abdominal wall defect located to the right side of the umbilicus and a large portion of the bowel protruding that was not covered by membrane. Histopathology of the placenta revealed that the twins were diamniotic monochorionic. Chromosomal analysis of cord blood showed normal karyotype (46,XX) in both newborns.


CONCLUSIONS
The cause of gastroschisis is unknown, although possible exogenous causes have been studied. The diagnosis of gastroschisis in twin pregnancy is always in late gestation. Therefore, maternal serum alpha fetoprotein screening and a detailed prenatal ultrasound evaluation are recommended in multifetal pregnancies.
Kao
Hui-Fen
HF
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Liang
Hsi-Mi
HM
Ou
Chi-Yu
CY
Hsu
Te-Yao
TY
D000293:Adolescent; D002585:Cesarean Section; D004200:Diseases in Twins; D005260:Female; D020139:Gastroschisis / Q000000981:diagnostic imaging* / Q000235:genetics / Q000601:surgery; D006801:Humans; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D014427:Twins; D016216:Ultrasonography, Prenatal