Open Access, Volume 2 Suspected Down Syndrome in one of non-identcal twins in Ile-Ife: A case report Case Report www.jcimcr.org Journal of Clinical Images and Medical Case Reports Received: Aug 23, 2021 Accepted: Sep 21, 2021 Published: Sep 28, 2021 Archived: www.jcimcr.org Copyright: ©Ubom AE (2021). *Corresponding Authors: Akaninyene Eseme Ubom Department of Obstetrics, Gynaecology, and Perinatol- ogy, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun state, Nigeria. Tel: +234-803-439-8468; Email: bedom2001@yahoo.com & akaninyeneubom@oauthc.com ISSN 2766-7820 Akaninyene Eseme Ubom 1 *; Omotade Adebimpe Ijarotmi 1,2 ; Michael Sylvester Archibong 1 ; Joseph Osagie Ugowe 3 1 Department of Obstetrics, Gynaecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun state, Nigeria. 2 Department of Obstetrics, Gynaecology, and Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun state, Nigeria. 3 Department of Paediatrics and Child Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun state, Nigeria. Abstract Nigerian women of southwest extracton have the highest rate of dizygotc twinning worldwide, with a reported incidence as high as 49 per 1000 deliveries. Among the risk factors for dizygotc twinning is advanced maternal age, which is also an independent risk factor for Down syndrome (trisomy 21). Down syndrome is the most com- mon chromosomal disorder afectng live born neonates. It occurs very rarely in twins, seen in 14-15 per million non-identcal twins. Down syndrome in one of non-identcal twins was frst reported in Nigeria by Otaigbe in Port Harcourt, in 2007. Herein, we report another case of suspected Down syndrome in one of non-identcal twins born to a 41-year-old grand multparous woman at the Oba- femi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun state, Nigeria. Keywords: Down Syndrome; dizygotc; fraternal; dichorionic; diam- niotc. Introducton With the increasing practce of assisted reproducton and as more women delay childbearing for various reasons (including career) worldwide, twinning incidence is rising globally [1,2]. The risk of Down syndrome increases with maternal age but occurs rarely in twins [3,4]. We present a case of suspected Down syn- drome in one of fraternal twins delivered to a 41-year-old mother. Case report Mrs. T. G. was a 41-year-old unbooked G9 P6 +2 with twin gestaton. Her pregnancy was spontaneously conceived, and she had received pregnancy care at an unorthodox, faith-based delivery unit in her locality. The only investgaton done in the antepartum were two obstetric scans, both of which revealed twin gestaton with the leading twin in breech. Other details could not be ascertained. Her pregnancy was uneventul, with no history suggestve of exposure to any known teratogen. She was a pety trader from Ile-Ife, Osun state, married to a 42-year- old driver. She, her husband, and all their other children were phenotypically normal, with no known chromosomal defect. They also had no known family history of chromosomal abnor- mality. She presented to our facility at 38 weeks + 5 days with foot prolapse of the leading twin, having been in labour at the un- orthodox, faith-based delivery unit, where she had received pregnancy care, where the foot had prolapsed following rupture of foetal membranes. She had emergency Caesarean delivery of dichorionic diamniotc twins. Twin 1 was male, weighed 2.95 kg,