PMC3515936_01
Sonogram of Case 1 recipient twin demonstrates well-developed lower limbs, partially developed abdomen and thorax, absent head and upper limbs and diffuse soft tissue edema.
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F1
Heart was absent, head and face were absent, and upper limbs were absent [Figure 1].
Sonogram of Case 1 recipient twin demonstrates thickened soft tissue along the dorsal aspect suggestive of cystic hygroma.
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F2
Cystic hygroma with diffuse soft tissue edema [Figure 2] and single umbilical artery [Figure 3] with reversal of flow [Figure 4] were detected.
Color Doppler sonographic image of Case 1 demonstrates two vessel umbilical cords with single umbilical artery.
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F3
Cystic hygroma with diffuse soft tissue edema [Figure 2] and single umbilical artery [Figure 3] with reversal of flow [Figure 4] were detected.
Pulsed Doppler sonographic image of Case 1 demonstrates reversal of flow in the umbilical artery.
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F4
Cystic hygroma with diffuse soft tissue edema [Figure 2] and single umbilical artery [Figure 3] with reversal of flow [Figure 4] were detected.
PMC3515936_02
Sonogram of Case 2 recipient twin demonstrates well-developed lower limbs with diffuse soft tissue edema.
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F5
The recipient twin had well-developed lower limbs that were directed posteriorly [Figure 5], underdeveloped abdomen with absent anterior abdominal wall, underdeveloped chest with hypoplastic ribs, absent cardia, underdeveloped upper limbs with single forearm bone, oligodactyly and club hand [Figure 6], cystic hygroma with diffuse soft tissue edema [Figure 7], microcephaly with dilated lateral and third ventricles [Figure 7], bilateral cleft lip/palate, and single umbilical artery with reversal of flow in umbilical vessels.
Sonogram of Case 2 recipient twin demonstrates club hand.
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F6
The recipient twin had well-developed lower limbs that were directed posteriorly [Figure 5], underdeveloped abdomen with absent anterior abdominal wall, underdeveloped chest with hypoplastic ribs, absent cardia, underdeveloped upper limbs with single forearm bone, oligodactyly and club hand [Figure 6], cystic hygroma with diffuse soft tissue edema [Figure 7], microcephaly with dilated lateral and third ventricles [Figure 7], bilateral cleft lip/palate, and single umbilical artery with reversal of flow in umbilical vessels.
Sonogram of Case 2 recipient twin demonstrates diffuse soft tissue edema and cystic hygroma (arrow).
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F7
The recipient twin had well-developed lower limbs that were directed posteriorly [Figure 5], underdeveloped abdomen with absent anterior abdominal wall, underdeveloped chest with hypoplastic ribs, absent cardia, underdeveloped upper limbs with single forearm bone, oligodactyly and club hand [Figure 6], cystic hygroma with diffuse soft tissue edema [Figure 7], microcephaly with dilated lateral and third ventricles [Figure 7], bilateral cleft lip/palate, and single umbilical artery with reversal of flow in umbilical vessels.
Specimen of Case 2 recipient twin demonstrates microcephaly, cystic hygroma, bilateral cleft lip, club hand, under developed chest and omphalocele.
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F8
A healthy male twin (pump twin) weighing 2.03 kg and an anomalous twin (recipient) were delivered [Figure 8].