Selective Termination of Pregnancy: About a Case of Anencephaly on a Bi-Chorial Twin Pregnancy

Abstract

Background: The discovery of a lethal or disabling malformation requires a thoughtful decision in the event of a termination of pregnancy on medical grounds. The termination of pregnancy can be selective in the case of multiple pregnancies if a twin is suffering from a serious condition. Objective: To report a case of anencephaly on a twin pregnancy and conduct a review of literature. Case: This is a 30-year-old woman carrying a pregnancy obtained after the third attempt at in vitro fertilization (IVF) with transfer of two embryos. No risk factor was found on this pregnancy except for the twinning. The diagnosis was made at 14 weeks +1 day during first term ultrasound, which discovered an on-going bi-chorial bi-amniotic twin pregnancy, with twin B (TB) carrying a defect on his head. A selective interruption was performed on TB at 16 weeks by cordonal injection with potassium chloride. The pregnancy went on without incident and with spontaneous vaginal delivery of the second twin at 39 weeks of pregnancy. Despite the selective termination, the pregnancy went on without any complication. Conclusion: Anencephaly on twin pregnancy is a rare occurrence. In a bichorial pregnancy, a selective feticide can improve the gestational age at birth.