title: Monochorionic twin fetus with VACTERL association after intracytoplasmic sperm injection.
abstract: We report a rare case of a monochorionic twin gestation after intracytoplasmic sperm injection (ICSI) in which one of the fetuses had VACTERL association. A 27-year-old woman became pregnant by ICSI and was found to have monochorionic twin fetuses. One fetus was noted to have the following anomalies: a multicystic, dysplastic left kidney with a hydroureter, and a dilated colon. A normal-sized stomach and normal amount of amniotic fluid were observed during the prenatal period with no other anomalies. The postnatal examination revealed hypospadias, and anal, esophageal, and duodenal atresia; thus, a diagnosis of VACTERL association was established. Although the prenatal diagnosis of this disorder is a challenge, even in a singleton, some of the characteristic features observed during antepartum ultrasonography may be a clue to the diagnosis, especially in a twin pregnancy after ICSI.
authors.affiliation: Departments of Obstetrics and Gynecology Neonatology, Iwate Medical University School of Medicine, Morioka, Japan.
authors.forename: Tomonobu
authors.initials: T
authors.lastname: Kanasugi
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kikuchi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Miyuki
authors.initials: M
authors.lastname: Terata
authors.forename: Chizuko
authors.initials: C
authors.lastname: Isurugi
authors.forename: Rie
authors.initials: R
authors.lastname: Oyama
authors.forename: Akimune
authors.initials: A
authors.lastname: Fukushima
authors.forename: Toru
authors.initials: T
authors.lastname: Sugiyama
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D002823:Chorion / Q000002:abnormalities* / Q000000981:diagnostic imaging; D004380:Duodenal Obstruction / Q000000981:diagnostic imaging / Q000473:pathology*; D004947:Esophagus / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005333:Fetus / Q000002:abnormalities*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007409:Intestinal Atresia; D007668:Kidney / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D017880:Limb Deformities, Congenital / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods; D013131:Spine / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D014132:Trachea / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D014427:Twins; D016216:Ultrasonography, Prenatal