Myelomeningocele in dizygotic twins

Results We present the case of a 29-year-old pregnant woman referred to our center due to dichorionic diamniotic twin pregnancy (concordant with sex), hypothyroidism and fetal spina bifida associated to Arnold-Chiari malformation type II. She denied the use of folic acid supplementation during pregnancy. The previous pregnancy was uneventful. The patient's husband was a 32-year-old and nonconsanguineous man with unremarkable medical history. The patient's sister had myelomeningocele. Ultrasound examination performed at 22 weeks' gestation showed, in both fetuses, lemon sign, flattened cerebellum (banana sign), and lumbosacral myelomeningocele. Ventriculomegaly was observed only in the second twin. Fetal echocardiography of the twins was normal, and fetal MRI confirmed these findings. The babies were born by cesarean section at 38 weeks of pregnancy. Clinical evaluation of them confirmed the prenatal diagnosis. The additional examination through cerebral ultrasonography showed the presence, in both newborns, of dilated ventricular system. The correction of myelomeningocele was carried out in the first day after birth in both neonates.