A case of uniovular Twins of which one child was normal and the other had the syndrome of mongolism

Extract

An African woman of about 40 years old reported to the out-patients' department on 31st January 1955 because of nausea and vomiting, with amenorrhoea of three months duration. Examination revealed a 2-months' pregnancy. She had six normal deliveries of which three children were still living.

On 3rd February she reported again, complaining of stomach-ache and diarrhoea. The stool examination showed some leucocytes and erythrocytes, but no amoebae, cysts or parasitic ova. On 23rd February the woman again reported, this time with a simple pharyngitis. She came again on 29th June for pre-natal examination and treatment. She had no complaints and was seen to be about 32 weeks pregnant, with a moderate degree of hydramnios. The foetal heart was inaudible.

On 1st August she was admitted to hospital in labour. The membranes were intact, the cervix fully dilatated and presentation was occipito-anterior of the vertex. Artificial rupture of the membranes released only a small amount of amniotic fluid, but labour proceeded normally with the usual quantity of fluid accompanying the birth. Immediately this child was born another bag of waters presented, which was ruptured to release about six pints of amniotic fluid. A second baby now presented by the breech and was delivered by Bracht's method. We noticed at once that this second baby was affected by mongolism.