# Aplasia cutis congenita as a complication of early interstitial laser embryo reduction in a case of monochorionic triamniotic triplet pregnancy ‒ a case report

## TL;DR

A rare case report shows that a skin condition called aplasia cutis congenita can occur in a surviving twin after laser embryo reduction in a triplet pregnancy.

## Contribution

Highlights aplasia cutis congenita as a rare complication of early interstitial laser embryo reduction in monochorionic triplet pregnancies.

## Key findings

- Interstitial laser embryo reduction can lead to aplasia cutis congenita in the surviving fetus.
- Parents should be informed about rare complications like skin scarring beyond miscarriage and fetal demise.
- Early intervention in monochorionic pregnancies requires expanded counseling to include potential skin abnormalities.

## Abstract

Monochorionic multiple pregnancies are being increasingly encountered. Early embryo reduction by interstitial laser is an option of therapeutic intervention. The patient counseling is mainly focused on miscarriage and fetal demise but this case report highlights that the counseling also needs to mention the possibility of developing Aplasia cutis congenita post intervention and that interstitial laser though technically feasible can have rare complications.

This was a uncommon form of twinning diagnosed as monochorionic triamniotic triplet pregnancy where the parents wanted to continue with a single fetus. Interstitial laser was performed in two of the embryos, which became papyraceous. The newborn on delivery was seen to have extensive skin scarring on the trunk which was diagnosed as Aplasia cutis congenita.

Awareness on complications on early interstitial laser procedures beyond miscarriage and fetal demise and the psychological impact on the parents of seeing the scarred neonate for the first time, if they have not been made aware of this complication.