Discordant twins with the smaller baby appropriate for gestational age – unusual manifestation of superfoetation A case report.docVIP

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Discordant twins with the smaller baby appropriate for gestational age – unusual manifestation of superfoetation A case report.doc

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Discordant twins with the smaller baby appropriate for gestational age – unusual manifestation of superfoetation A case report

BMC Pediatrics BioMedCentral Case report Open Access Discordant twins with the smaller baby appropriate for gestational age – unusual manifestation of superfoetation: A case report Noopur Baijal?1, Mohit Sahni?1, Neeraj Verma?1, Amit Kumar?1, Nittin Parkhe?2 and Jacob M Puliyel*?1 Address: 1Department of Pediatrics and Neonatology St Stephens Hospital, Tis Hazari, Delhi 110054, India and 2Department of Radiology, St Stephens Hospital, Tis Hazari, Delhi 110054, India Email: Noopur Baijal - doc_noopur@yahoo.co.in; Mohit Sahni - sahni.mohit1@; Neeraj Verma - drvermaneeraj@; Amit Kumar - amitpaed2006@; Nittin Parkhe - nittinparkhe@; Jacob M Puliyel* - puliyel@ * Corresponding author ?Equal contributors Published: 19 January 2007 Received: 19 May 2006 Accepted: 19 January 2007 BMC Pediatrics 2007, 7:2 doi:10.1186/1471-2431-7-2 This article is available from: /1471-2431/7/2 ? 2007 Baijal et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Documentation of superfoetation is extremely rare in humans., The younger foetus has invariably been small for gestational age (estimated from the date of the last menstrual bleed) in all the cases reported in the literature. We report a case where the younger twin was of appropriate size for gestation. Case Presentation: The first of twins was of 32 weeks gestation and the baby was of appropriate size and development for the gestational age. The second twin was of 36 weeks gestation. Gestational age was estimated with the New Ballard score, x-ray of the lower limbs, dental age on x-ray, and ophthalmic examination. Conclusion: Bleeding on implantation of the first foetus probably helped demarcate the two pregnancies. Dental age an