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Case Reports
.2013 May;3(1):37-40.
doi: 10.1055/s-0032-1331378. Epub 2012 Dec 31.

Second-trimester diagnosis of triploidy: a series of four cases

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Case Reports

Second-trimester diagnosis of triploidy: a series of four cases

J B Wick et al. AJP Rep.2013 May.

Abstract

Triploidy occurs in 2 to 3% of conceptuses and accounts for approximately 20% of chromosomally abnormal first-trimester miscarriages. As such, triploidy is estimated to occur in 1 of 3,500 pregnancies at 12 weeks', 1 in 30,000 at 16 weeks', and 1 in 250,000 at 20 weeks' gestation. We present a series of four cases of second-trimester triploidy diagnosed at our center within a 1-year timeframe. This is remarkable, as the delivery volume at our institution is roughly 2,500/y. All patients were at least 19 weeks' gestation, with multiple abnormalities identified on prenatal ultrasound at 18 to 20 weeks' gestation; all fetuses had lethal anomalies, but anomalies were not consistent between cases. All patients elected for induction of labor before 24 weeks' gestational age. Two of the four cases had amniocentesis and chromosome analysis prior to delivery, and two cases had chromosome analysis performed on fetal tissue after delivery. All fetuses were examined following delivery. This case series demonstrates that the diagnosis of triploidy may not be obvious based on ultrasound and physical examination findings and highlights the importance of routine chromosome analysis on all prenatal diagnoses of multiple congenital anomalies prior to consideration of more complex genetic testing.

Keywords: phenotype; second trimester; triploidy; ultrasound.

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Figures

Fig. 1
Fig. 1
Transverse view of the fetal abdomen in case 1, demonstrating the classic “double bubble” sign consistent with duodenal atresia. The two cystic structures represent an enlarged fluid-filled stomach and proximal duodenum. The pylorus between the stomach and duodenum is also dilated and visible.
Fig. 2
Fig. 2
Physical exam of fetus in case 1 revealed 3,4 syndactyly of the right hand.
Fig. 3
Fig. 3
The fetus in case 2, demonstrating growth restriction, relative macrocephaly with facial asymmetry, and low-set ears. The sternal length is shortened, and ribs are splayed (A). Malformations of the lower extremities in case 2 included 4,5 syndactyly of the right foot and equinovarus (B).
Fig. 4
Fig. 4
Chromosomal analysis in case 4 revealed a 69,XXX karyotype.
See this image and copyright information in PMC

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References

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