Greiner G, Bock B, Sammler K, Feige A
Frauenklinik II im Klinikum Nürnberg.
Geburtshilfe Frauenheilkd. 1991 May;51(5):355-6. doi: 10.1055/s-2007-1026156.
Malformations are found twice as often in twins than in singletons. In the following case, we report on a twin pregnancy with anencephaly and polyhydramnion of the leading twin I, which was first diagnosed after 28 weeks of pregnancy. The foetal disease of twin I led to an appreciable dyspnoea of the mother that exacerbated to an incipient respiratory failure by the thirty-second week of pregnancy. The projected termination of pregnancy by Caesarean section based on a maternal indication was not performed, but instead a selective foetocide of the diseased twin. The live twin was delivered spontaneously without complications after thirty-eight weeks of pregnancy. The obstetric and legal ethical problems are discussed.
畸形在双胞胎中的发现几率是单胎的两倍。在以下病例中，我们报告一例双胎妊娠，其中主胎儿I为无脑儿并伴有羊水过多，在妊娠28周后首次确诊。胎儿I的疾病导致母亲出现明显的呼吸困难，到妊娠第32周时恶化为早期呼吸衰竭。基于母亲的指征计划进行剖宫产终止妊娠，但未实施，而是对患病胎儿进行了选择性灭胎。存活的胎儿在妊娠38周后自然分娩，无并发症。文中讨论了产科及法律伦理问题。
