Acardiac Twin-Twin Reversed Arterial Perfusion Sequence.
- Author:
Sun Gyoeng KIM
1
;
Hui Gyeong SEO
;
Yun Sook KIM
Author Information
1. Department of Obstetrics and Gynecology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea. drsook@schmc.ac.kr
- Publication Type:Case Report
- Keywords:
Pumping twin;
Acardiac twin;
Monozygous twin pregnancy;
Twin reversed arterial perfusion
- MeSH:
Adrenal Cortex Hormones;
Adult;
Cardiomegaly;
Cesarean Section;
Chungcheongnam-do;
Comprehension;
Edema;
Female;
Fetus;
Gestational Age;
Head;
Heart;
Humans;
Hypertension;
In Vitro Techniques;
Perfusion*;
Polyhydramnios;
Pregnancy;
Pregnancy, High-Risk;
Pregnancy, Twin;
Pregnant Women;
Twins;
Ultrasonography;
Umbilical Arteries;
Upper Extremity
- From:Soonchunhyang Medical Science
2016;22(1):42-45
- CountryRepublic of Korea
- Language:English
-
Abstract:
In general, twin pregnancy represents a high-risk pregnancy. The monozygous twin of all twin pregnancy is a real challenge for the obstetrician due to the severe complications that may arise during its development. An extremely uncommon, severe complication of monozygous twin pregnancy, which we recently experienced in Soonchunhyang University Cheonan Hospital, was a monochorionic diamniotic twin pregnancy with acardiac twin-twin reversed arterial perfusion sequence. An acardiac twin presented no heart, underdeveloped inferior part of the body, being transfused by the other fetus (pumping twin) by umbilical vessels. We report a 33-year-old pregnant woman, with a history of in vitro fertilization-embryo transfer in the second pregnancy, who presented with generalized edema, abdominal discomfort, and high blood pressure at 33 weeks' gestation. By ultrasonography, one of the babies is normally developed but in the other baby, head, upper extremities, and cardiac activity cannot be detected. The pumping twin was cardiomegaly, polyhydramnios, absent diastolic wave on the umbilical artery, and small for gestational age. We decided to terminate the pregnancy by primary cesarean section after administration of corticosteroids. The comprehension of this case is compulsory in order to provide maximum survival opportunity to the viable baby.
