Acardiac twins: Pathophysiology, diagnosis, outcome and treatment. Six cases and review of the literature

Fetal Diagnosis and Therapy

Volumn 14, Issue 1, 1999, Pages 53-59

  Søgaard, Kirsten ^a,b   Skibsted, Lillian ^a   Brocks, Vibeke ^a  

^a Rigshospitalet   (Denmark)

^b NONE   (Denmark)

Author keywords

Acardiac twins; Chorionicity; Twins; Ultrasound

Indexed keywords

BETA ADRENERGIC RECEPTOR STIMULATING AGENT; CARDIOTOXIN; INDOMETACIN; MAGNESIUM SULFATE; PROSTAGLANDIN INHIBITOR; STEROID;

ACARDIAC TWINNING; AMNIOCENTESIS; ARTERY PERFUSION; ARTICLE; BLOOD TRANSFUSION REACTION; CARDIOVASCULAR DISEASE; CHORION; CONSERVATIVE TREATMENT; DIAGNOSTIC ERROR; DIGITALIZATION; FEMALE; FETUS; FETUS LUNG MATURATION; GESTATIONAL AGE; HEART DISEASE; HUMAN; HYSTEROTOMY; KIDNEY ARTERY; LASER COAGULATION; LUNG DISEASE; LUNG EDEMA; MATERNAL WELFARE; NECROTIZING ENTEROCOLITIS; OUTCOMES RESEARCH; PREMATURITY; PRENATAL DIAGNOSIS; PRIORITY JOURNAL; SELECTIVE ABORTION; SIDE EFFECT; TRICUSPID VALVE REGURGITATION; TWIN PREGNANCY; TWIN TWIN TRANSFUSION SYNDROME; ULTRASOUND; UTERUS CONTRACTION; VASOCONSTRICTION;

DELIVERY, OBSTETRIC; FEMALE; HEART DEFECTS, CONGENITAL; HUMANS; PREGNANCY; PREGNANCY OUTCOME; TRIPLETS; TWIN STUDIES; ULTRASONOGRAPHY, PRENATAL;

EID: 0032966283     PISSN: 10153837     EISSN: None     Source Type: Journal    
DOI: 10.1159/000020889     Document Type: Article

References (34)

1. Pretorius D, Leopold G, Moore T, Benirschke K, Sivo JJ: Acardiac twin: Report of Doppler sonography. J Ultrasound Med 1988;7:413-416.
2. Dangel J, Roszkowski T, Wejman J: Acardiac fetus - Echocardiographical and pathological findings. Arch Perinatal Med 1996;2:86-89.
3. Eckardstein S, Reihs T, Crombach G: Constriction of an extremity after amnioreduction in a TRAP-like sequence. Fetal Diagn Ther 1997; 12:50-53.
4. Van Allen MI, Smith DW, Shepart TH: Twin reversed arterial perfusion (TRAP) sequence: A study of 14 twin pregnancies with acardius. Semin Perinatol 1983;7:285-293.
5. Langman J: Medical Embryology, ed 3. Baltimore, Williams & Wilkins Co, 1975.
6. Divon M, Weiner Z: Ultrasound in twin pregnancy. Semin Perinatol 1995;19:404-412.
7. Cunningham FG, MacDonald PC, Gant NF, Leveno KJ. Gilstrap LC: Williams Obstetrics, ed 19. Norwalk, Appleton & Lange, 1993.
8. James WH: A note on the epidemiology of acardiac monsters. Teratology 1977;16:211-216.
9. Schinzel AGL, Smith DW, Miller JR: Monozygotic twinning and structural defects. J Pediatr 1979;95:921-930.
10. Romero R: Twin reversed arterial perfusion sequence; in Romero R (ed): Prenatal Diagnosis of Congenital Anomalies. Norwalk, Appleton & Lange, 1988.
11. Hecher K, Ville Y, Nicolaides KH: Color Doppler ultrasonography in the identification of communicating vessels in twin-twin transfusion syndrome and acardiac twins. J Ultrasound Med 1995;14:37-40.
12. Coulam CB: First trimester diagnosis of acardiac twins. Obstet Gynecol 1996;88:729.
13. Chemielnicka-Kopaczyk M, Bieganska E, Kornacka M, Jasinski J, Wender-Ozegowska E, Biczysko R: Acardiac cephalic in triplet pregnancy. Arch Perinat Med 1996;1:91-97.
14. Bieber FR, Nance WE, Morton CC, Brown JA, Redwine FO: Genetic studies of an acardiac monster: Evidence of polar body twinning in man. Science 1981;213:775-777.
15. Fries M, Goldberg JD, Golbus MS: Treatment of acardiac-acephalus twin gestations by hysterotomy and selective delivery. Obstet Gynecol 1992;79:601-604.
16. Porreco R, Barton SM, Haverkamp AD: Occlusion of umbilical artery in acardiac, acephalic twin. Lancet 1991;337:326-327.
17. Benirschke K, Harper V: The acardiac anomaly. Teratology 1977;13:311-316.
18. Yoshida K: Acardiac twin pregnancy: Clinical study of 9 cases. Arch Perinat Med 1996;2: 166.
19. Napolitani FH, Schreiber I: The acardiac monster: A review of the world literature and presentation of 2 cases. Am J Obstet Gynecol 1960;80:582-589.
20. Moore T, Gale S, Benirschke K: Perinatal outcome of forty-nine pregnancies complicated by acardiac twinning. Am Obstet Gynecol 1990; 163:907-912.
21. Sepulveda WH, Quiroz VH, Guiliano A, Henriques R: Prenatal ultrasonographic diagnosis of acardiac twin. J Perinat Med 1993;21:241-246.
22. Simpsom PC, Trudinger BJ, Walker A: The intrauterine treatment of fetal cardiac failure in a twin pregnancy with an acardiac acephalic monster. Am J Obstet Gynecol 1983;147:842.
23. Cabrol D, Landesman R, Muller J, Uzan M, Sureau C, Saxena BB: Treatment of polyhydramnios with prostaglandin synthetase inhibitor (indomethacin). Am J Obstet Gynecol 1987;157:422-426.
24. Ash K, Harman CR, Gritter H: TRAP sequence - Successful outcome with indometacin treatment. Obstet Gynecol 1990;76:960-962.
25. Trespidi L, Boschetto C, Caravelle E, Villa L, Kustermann A, Nicolini U: Serial amniocenteses in the management of twin-twin transfusion syndrome: When is it valuable? Fetal Diagn Ther 1997;12:15-20.
26. Platt L, DeVore GR, Bieniarz A, Banner P, Rao R: Antenatal diagnosis of acephalus acardia: A proposed management scheme. Am J Obstet Gynecol 1983;146:857-859.
27. Chitkara U, Berkowitz RL, Wilkins IA, Lynch L, Mehalek KE, Alvarez M: Selective second-trimester termination of the anomalous fetus in twin pregnancies. Obstet Gynecol 1989;73: 690-694.
28. Sepulveda W, Bower S, Hassan J, Fisk N: Ablation of acardiac twin by alcohol injection into the intra-abdominal umbilical artery. Obstet Gynecol 1995;86:680-681.
29. Hamada H, Okane M, Koresawa M, Kubo T, Iwasaki H: Fetal therapy in utero by blockage of the umbilical blood flow of acardiac monster in twin pregnancy. Nippon Sanka Fujinka Gakkai Zasshi 1989;41:1803-1809.
30. Roberts RM, Shah DM, Jeanty P, Beattie JF: Twin, acardiac, ultrasound-guided embolization. Fetus 1991;1:5-10.
31. Foley MR, Clewell WH, Finberg HJ, Mills MD: Use of the Foley Cordostat grasping device for selective ligation of the umbilical cord of an acardiac twin: A case report. Am J Obstet Gynecol 1995;172:212-214.
32. Quintero RA, Reich H, Puder KS, Evans MI, Cotton DB, Romero R: Umbilical-cord ligation of an acardiac twin by fetoscopy at 19 weeks of gestation (brief report). N Engl J Med 1994; 330:469-471.
33. McCurdy C, Childers JM, Seeds JW: Ligation of the umbilical cord of an acardiac-acephalus twin with an endoscopic intrauterine technique. Obstet Gynecol 1993;82:708-711.
34. Arias F, Sunderji S, Gimpelson R, Colton E: Treatment of acardiac twinning. Obstet Gynecol 1998;91:818-821.