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2014, Number 4

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Revista Habanera de Ciencias Médicas 2014; 13 (4)

Twin pregnancy with acardiac foetus: Case presentation

Rivera VAC, García JME

Language: Spanish
References: 19
Page: 561-569
PDF size: 120.33 Kb.


ABSTRACT

Introduction: among several peculiarities of gestation twins (univiteline) monochorionic is sequence of Twin Reverse Arterial Perfusion (TRAP sequence) or fetus-fetal transfusion. TRAP is a serious complication whereby the affected twin is been perfused in a reverse manner through arterio-arterial and veno-venous anastomoses by another twin; resulting in an abnormal acardiac foetus and other normal, but with hemodynamic consequences in the latter, due to this complication.
Objective: illustrate a twin pregnancy with an acardius acephalus (parasite) twin diagnosis by antenatal, ante partum ultrasound; since it is seldom reported in our environment.
Case Presentation: the results of a 17-year-old primigravida pregnant woman's with a twin pregnancy of 36.3 weeks, diagnosed by Ultra sound (US) are presented in this article. Four previous ante-natal checks up were retrieved before she went into labour. An evaluative US was carried out; showing a live foetus in a cephalic presentation, accompanied by an amorphous mass that was concluded as a malformed foetus in a twin pregnancy. The patient was referred to the National Regional Escuintla Hospital (NREH). A caesarean section was performed. A female newborn of 2.37 kg weight and an amorphous mass - corresponding to a malformed foetus- were found. A uni-chorionic, uni-amniotic placenta was found, as well as a foetus-foetal blood perfusion (from normal to malformed) that kept "alive" the malformed foetus until the delivery. Intra partum foetal death of the second (amorphous) foetus was noticed. The body was sent to the department of pathology for post-mortem study service. The findings of the post-mortem are presented in this report.
Conclusions: acardiocephalus twin pregnancy by reverse foetus-fetal transfusion is quite uncommon in our country, due to early and advanced antenatal control and diagnosis. Early detection of such cases provides a good tool to avoid intra partum and postpartum neonatal deaths, thus, contributing to decrease infant mortality rate.


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