Triplet pregnancy with acardius acranius after preimplantation diagnosis

Objective: To report the first case of fetal malformation after preimplantation diagnosis for Duchenne muscular dystrophy (DMD). Design: Case report. Setting: Perinatal center in a university hospital. Patient(s): A conductor for DMD in her third pregnancy. Intervention(s): Preimplantation diagnosis was performed in an outside hospital. In our center, a dichorionic triplet pregnancy with acardius acranius was diagnosed. The anastomosis between the "pump"-twin and the fetus with acardius was embolized with histoacryl to prevent worsening cardiac insufficiency of the "pump"-twin. Main Outcome Measure(s): Pregnancy outcome. Result(s): The anastomosis between the "pump"-twin and the fetus with acardius was occluded successfully. Premature preterm rupture of membranes led to rapid labor and delivery at 24 + 5 weeks' gestation. The smaller girl died of severe hyaline membrane disease, whereas the other infant had no major clinical problems and has developed well. Conclusion(s): There might be an association between embryo biopsy and fetal malformations. The setting up of a birth register after embryo biopsy is strongly recommended.