Aplasia Cutis Congenita in Surviving Co-twin of Monochorionic Diamniotic Twins with Vanishing Twin Syndrome

Abstract

 A male infant weighing 2,679g was delivered vaginally at 39 weeks and 4 days of gestation. He was the surviving co-twin of a monochorionic diamniotic（MD）twin pregnancy achieved by natural conception, while death of the other fetus occurred at 14 weeks of gestation. The extensive skin defect on his abdomen was noticed at birth in the NICU was diagnosed as aplasia cutis congenita and was initially covered using Vaseline-impregnated gauze as a conservative treatment option. On the fourth day of life, treatment involved AQUACEL Ag® due to the persistent yellow exudate around the lesion area since the third day of life. Subsequently, the exudate ceased, as re-epithelialization of the lesion occurred; therefore, the patient was discharged on the 19th day of life. In the following month, the lesion eventually cicatrized. This is a rare but noteworthy condition which may present with the surviving co-twin of a monochorionic diamniotic（MD）twin pregnancy with vanishing twin syndrome. In this case, maintaining a moist environment and applying AQUACEL Ag® were both effective.