De la Calle M, Arrieta S, Herrero B, Omeñaca F, Bartha J L
Clin Exp Obstet Gynecol. 2014;41(2):208-10.
Prevalence ofanencephaly in dichorionic twins is higher than in singleton pregnancies. The authors report two cases with two different management strategies.
CASE 1: Spontaneous dichorionic diamniotic twin pregnancy with the second twin diagnosed with anencephaly at 12 weeks gestation. Selective feticide was performed at the age of 13.2 weeks. Vaginal delivery occurred at 39 weeks, and birth weight was 2,850 g.
CASE 2: Dichorionic diamniotic twin pregnancy discordant for anencephaly in the second twin was diagnosed at 13 weeks gestation. An expectant management was decided. Preterm delivery occurred at 35 weeks due to hydramnios of the affected fetus, delivering a healthy newborn weighing 2,300 g and an anencephalic neonate who died immediately after delivery.
Anencephaly should be diagnosed as soon as possible, idealistically at 11-13+6 weeks ultrasound (US) scan, in order to offer the most appropriate counselling to the parents, ranging from selective feticide or expectant management. This short series suggests that selective early feticide may increase gestational age and birth weight.
双绒毛膜双胎中无脑儿的发生率高于单胎妊娠。作者报告了两例采用不同管理策略的病例。
病例1：自然受孕的双绒毛膜双羊膜囊双胎妊娠，孕12周时诊断出第二胎儿为无脑儿。在孕13.2周时实施了选择性减胎术。孕39周时经阴道分娩，出生体重为2850克。
病例2：孕13周时诊断出双绒毛膜双羊膜囊双胎妊娠，第二胎儿为无脑儿。决定采取期待治疗。因患侧胎儿羊水过多，孕35周时早产，娩出一名体重2300克的健康新生儿和一名出生后即刻死亡的无脑儿新生儿。
应尽早诊断无脑儿，理想情况下在孕11 - 13⁺⁶周超声检查时诊断，以便为父母提供最合适的咨询，范围包括选择性减胎术或期待治疗。这一简短系列病例表明，选择性早期减胎术可能会增加孕周和出生体重。
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