Infants born at 22–23 weeks rarely survive, and most develop severe complications, especially in the case of multiple births. This age is considered the threshold for active intervention. We report the survival of twins born at 22 2/7 weeks gestation. Recently, advances in neonatal care have improved infant survival.

In 2020, we had reported one of the few cases of trisomy 13 with ectrodactyly, a rare form of limb deformity. Herein, we report another newborn who suffered from trisomy 13 and ectrodactyly. The patient also possessed another unusual manifestation of trisomy 13, congenital diaphragmatic hernia, a life- threatening pathology.