Acardiac Twin.
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Date
2014-07
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Abstract
Acardiac anomaly is a rare complication of multiple pregnancies. It is a hemodyamically
disadvantaged nonviable twin which occurs in association with a twin reversed arterial
perfusion sequence (TRAP). In TRAP, blood flows from an umbilical artery of the pump
twin in reverse direction into umbilical artery of the perfused (or acardiac) twin via an
arterial to arterial (AA) anastomosis. Its blood is poorly oxygenated and results in variable
degrees of deficient development of the head, heart, and upper limb structures. The lower
half of the body is usually better developed, which may be explained by the mechanism of
perfusion. The pump twin is at risk of heart failure and problems related to preterm birth
with a reported mortality of 50-75%. We present a case of multiple pregnancy with
acardiac twin in a 26 year old lady with gestational diabetes mellitus. During ante natal
check up several ultrasonographic (USG) screening showed twin pregnancy with one
healthy fetus and the other fetus with inconspicuous anatomy and structure. Repeat USG at
36th week of gestation diagnosed twin pregnancy with acardiac twin. Strikingly the pump
twin did not develop the usual complications and was delivered by cesarean section at 37th
week of gestation.
Description
Keywords
Acardiac, twin
Citation
MaherunnessaM S, Begum Rahima, Jahan Samsad, Bela Shamsunnahar, Habib Syeda Riffat Binta, Shermin Shahana. Acardiac Twin. Delta Medical College Journal. 2014 July; 2(2): 77-88.