ABSTRACT
A 25-year-old female with a twin pregnancy presented to the fetal center for counseling. A prenatal MRI after an initial ultrasound (US) at 21 weeks of gestation showed Twin A with multiple congenital anomalies including a possible closed neural tube defect, spinal kyphosis, hyperextended right foot, ambiguous genitalia, clitoromegaly, and a cystic abdominal mass. Twin B had no abnormalities. The parents were counseled about the congenital anomaly and decided to proceed with the pregnancy. The delivery was planned in a tertiary hospital with a neonatal intensive care unit (NICU) able to care for babies born at less than 32 weeks gestation as well as babies born with critical illnesses at all gestational ages, with access to a full range of pediatric medical and surgical subspecialities.
