{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:40:01Z","timestamp":1756309201677,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,3,27]]},"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>A woman\u2019s chances of having a child with Down syndrome increases with age. By age 40, the risk of conceiving a child with Down syndrome is about 1 in 100. We report a rare case of dizygotic dichorionic diamniotic twin pregnancy conceived via in vitro fertilisation, with both twins having trisomy 21. Both fetuses were independently detected to be at high risk of autosomal trisomy, initially via first-trimester screening and subsequently via invasive definitive diagnostic tests (ie, chorionic villus sampling and amniocentesis).<\/jats:p>\n               <jats:p>Diagnosis of trisomy 21 has to be made via initial non-invasive prenatal screening, followed by further rigorous and accurate invasive pregnancy testing for confirmation. The gravity of the results necessitates high detection rates and high specificity of prenatal screening tests. Management of the patient must be multidisciplinary and supportive in nature, involving extensive and non-directive pregnancy counselling and management, genetic counselling and management of psychological distress.<\/jats:p>","DOI":"10.1136\/bcr-2018-227608","type":"journal-article","created":{"date-parts":[[2019,4,15]],"date-time":"2019-04-15T07:49:10Z","timestamp":1555314550000},"page":"e227608","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Trisomy 21 in both fetuses in a DCDA twin pregnancy"],"prefix":"10.1136","volume":"12","author":[{"given":"Jiawen","family":"Ong","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arundhati","family":"Gosavi","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, National University Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arijit","family":"Biswas","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, National University Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahesh","family":"Choolani","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, National University Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,4,14]]},"reference":[{"key":"2025082708072088000_12.4.e227608.1","doi-asserted-by":"crossref","first-page":"45-67","DOI":"10.1016\/j.ajog.2004.03.090","article-title":"Nuchal translucency and other first-trimester sonographic markers of chromosomal abnormalities","volume":"191","author":"Nicolaides","year":"2004","journal-title":"Am J Obstet Gynecol"},{"key":"2025082708072088000_12.4.e227608.2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(199601)16:1<29::AID-PD801>3.0.CO;2-K"},{"key":"2025082708072088000_12.4.e227608.3","doi-asserted-by":"crossref","first-page":"764-73","DOI":"10.1097\/OGX.0000000000000001","article-title":"Down syndrome screening in assisted conception twins: an iatrogenic medical challenge","volume":"68","author":"Ben-Ami","year":"2013","journal-title":"Obstet Gynecol Surv"},{"key":"2025082708072088000_12.4.e227608.4","doi-asserted-by":"crossref","first-page":"283.e1","DOI":"10.1016\/j.ajog.2008.07.010","article-title":"First-trimester screening with nasal bone in twins","volume":"199","author":"Cleary-Goldman","year":"2008","journal-title":"Am J Obstet Gynecol"},{"key":"2025082708072088000_12.4.e227608.5","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dms010"},{"key":"2025082708072088000_12.4.e227608.6","doi-asserted-by":"crossref","unstructured":"Bellver J , Casanova C , Garrido N , et al . 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