Acardiac twin: Conservative management

Deepa V Kanagal,Lokeshchandra C Hanumanalu,Mahendra Gangadhariah,Maitri M Kulkarni,Mangala Srikantaswamy,Rashmi M Devaraj

doi:10.5348/ijcri-2013-09-370-cii-14

Abstract

Introduction: Acardiac twin is a rare anomaly occurring in 1 in 35,000 pregnancies. the outcome is fatal for the acardiac twin with a 50–75% mortality of the normal pump twin. Management options include conservative management, medical therapy, occlusion of connecting vessels and selective termination of the acardiac twin. the Management of a twin pregnancy complicated by an acardiac twin is a challenge because the continuous growth of the acardiac fetus is deleterious to the healthy pump twin leading to cardiac insufficiency, polyhydramnios, prematurity and even death of the normal twin. case report: We report three cases of acardiac twinning which presented with different manifestations, acardius acephalus, acardius myelocephalus and acardius amorphous. All the three cases were managed conservatively with

Highlights

Acardiac twin is a rare anomaly occurring in 1 in 35,000 pregnancies
Acardiac twinning or Twin Reversed Arterial Perfusion (TRAP) is a rare anomaly occurring in monozygotic multiple pregnancies with an incidence of 1% and in 1 in 35,000 pregnancies [1]
Acardiac twinning or TRAP sequence is a rare congenital anomaly of monozygotic multiple pregnancy due to abnormal placental anastomosis characterized by formation of a malformed fetus with an absent or rudimentary heart and other structures

Summary

Introduction

Acardiac twinning or Twin Reversed Arterial Perfusion (TRAP) is a rare anomaly occurring in monozygotic multiple pregnancies with an incidence of 1% and in 1 in 35,000 pregnancies [1]. Case 1: A 30-year-old third gravida with previous two uneventful vaginal deliveries came to us for the first time at 34 weeks of gestation with twin pregnancy in active labor. She delivered a normal female baby of IJCRI – International Journal of Case Reports and Images, Vol 4 No 9, September 2013. Ultrasound revealed twin pregnancy with one normally formed fetus of 24 weeks and another fetus with a partially formed head with hydrocephalus and enlarged lateral ventricle (Figure 6A–B). Case 3: A second gravida of 21 years of age with a previous cesarean section presented at 24th week of gestation with twin pregnancy.

Findings

DISCUSSION

CONCLUSION