Arşiv
Ara
Dergi Kimliği
Online ISSN
1305-3132
Yayın Dönemi
1993 - 2021
Editor-in-Chief
Cihat Şen, Nicola Volpe
Editors
Daniel Rolnik, Mar Gil, Murat Yayla, Oluş Api
Twin pregnancy complicated by acardiac fetus: A case report
S. Özkan, S. Özeren, A. Çorakçı , Ü. Özkaya , M. Göktan , İ. Yücesoy
Künye
Twin pregnancy complicated by acardiac fetus: A case report. Perinatoloji Dergisi 2002;10(3):197-198
Yazar Bilgileri
- University of Kocaeli School of Medicine Department of Obstetrics and Gynecology Kocaeli TR
Yayın Geçmişi
Çıkar Çakışması
Çıkar çakışması bulunmadığı belirtilmiştir.
Amaç
Acardiac twinning (Twin reversed arterial perfusion secıuence, TRAP) is a iare complication of multifetal gestation occurring 1% of monozygotic twin pregnancies or 1 in 35000 births. An abnormal vascular communication consisting of anastomoses between embryos leading to reversed flow of blood to the hemodynamically disadvantaged or recipient twin with the resulting secondary atrophy of the heart and dependent organs. Inadequate perfusion leads to characteristic anomalies including acardius and acephalus. The other twin "pump twin" is structurally normal but carries the risk of cardiac failure associated with a mortality rate of 50%. The larger the acardiac mass at birth, the greater was the risk of adverse pregnancy outcome, particularly if the ratio of the weight of the acardiac twin to the pump twin exceeded 70%. İn some cases a single umbilical artery or chromosomal anomaly in the acardiac twin may be present.
Olgu
Sonuç
The diagnosis of acardius in multiple pregnancy with no fetal heart tone must be ruled out in every case so that proper counselling, management and avoidance of complications can be achieved. Elective termination, observation, (USG and cardiotocography), nonsurgical intervention for cardiac failure (Digoxin therapy), laser coagulation of the umbilical cord of acardiac fetus under sonoendoscopic control are presented to be therapeutic choices. Percutaneous umbilical cord ligation is another approach under trial. Another option of percutaneous intrafetal alcohol injection is found to be widely available, less invasive and simpler recently advocated endoscopic techniques.
Acardiac twinning (Twin reversed arterial perfusion secıuence, TRAP) is a iare complication of multifetal gestation occurring 1% of monozygotic twin pregnancies or 1 in 35000 births. An abnormal vascular communication consisting of anastomoses between embryos leading to reversed flow of blood to the hemodynamically disadvantaged or recipient twin with the resulting secondary atrophy of the heart and dependent organs. Inadequate perfusion leads to characteristic anomalies including acardius and acephalus. The other twin "pump twin" is structurally normal but carries the risk of cardiac failure associated with a mortality rate of 50%. The larger the acardiac mass at birth, the greater was the risk of adverse pregnancy outcome, particularly if the ratio of the weight of the acardiac twin to the pump twin exceeded 70%. İn some cases a single umbilical artery or chromosomal anomaly in the acardiac twin may be present.
Olgu
Wc report acardiac twinning in a 12 weeks of multiple pregnancy. No fetal heart beat was recognized in one of the fetuses in a monochorionic diamniotic twin pregnancy. Absence of upper extremeties and a small calvarium-like structure covered with massive edema in the same fetus provided the diagnosis. Termination of pregnancy was not approved by the patient. She is stili under control lor probable complications of this uncommon malformation of multiple gestation.
Sonuç
The diagnosis of acardius in multiple pregnancy with no fetal heart tone must be ruled out in every case so that proper counselling, management and avoidance of complications can be achieved. Elective termination, observation, (USG and cardiotocography), nonsurgical intervention for cardiac failure (Digoxin therapy), laser coagulation of the umbilical cord of acardiac fetus under sonoendoscopic control are presented to be therapeutic choices. Percutaneous umbilical cord ligation is another approach under trial. Another option of percutaneous intrafetal alcohol injection is found to be widely available, less invasive and simpler recently advocated endoscopic techniques.
Anahtar Kelimeler
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Makale Türü Bildiri Özeti |
|
Sayfalar 197-198 |
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Künye |
| Perinatoloji Dergisi 2002; 10 (3) |
| PDF Olarak İndir |