In monochorionic twin pregnancy, two conditions that may progress to fetal hydrops are twin-to-twin transfusion syndrome and acardiac twin
, also known as twin reversed arterial perfusion (TRAP) sequence.
Para la construccion del algoritmo, se realizo una busqueda de literatura en las bases de datos Hinari y Pubmed con las palabras clave: acardiac twin
, conjoined twins, congenital teratoma, fetus in fetus, macerated co-twin.
(9,10) The presence of abnormal vascular communications may also cause limb reduction defects and the rare acardiac twin
"Since the acardiac twin
would not survive," reported the surgeons in the Massachusetts case, "the incision for separation was performed far toward her side of the fusion plane so that her tissue could be used to achieve complete closure of the ventral defect in the surviving twin." If both twins had been older, capable of discussing with us their hopes and dreams for the future, it would have been much more difficult and more controversial for the doctors and parents to make the decision to sacrifice one so that the other could live.
TRAP Sequence, frequently referred to as acardiac twin
syndrome, is a rare complication of monochorionic twin gestation with an incidence of 1/30000-1/35000 deliveries or 1% of all monochorionic pregnancies .
or TRAP sequence is a rare complication of monochorionic twin pregnancies.1 Multiple pregnancy accounts for 1.5% of all pregnancies, acardiac twin
incidence is 1 per 35,000 birth among 1% of monozygotic twins.
Robie and co in 1989 stated that frequently the acardiac twin
has chromosomal anomalies but the PUMP twin usually has a normal karyotype and such anomalous fetuses have a higher rate of intra uterine demise.
Twin pregnancy with acardiac results from an artery-to-artery placental anastomosis in which the pump twin, morphologically normal, perfuses the abnormal acardiac twin
in a reversed circulation.
The donor twin pumps deoxygenated blood via vascular anastomosis to acardiac twin
. This blood flow is characterized by reversed arterial perfusion (hence TRAP).
INTRODUCTION: Acardiac twin
is an anomaly unique to monochorionic multiple pregnancies, characterized by formation of malformed fetus with an absent or rudimentary (nonfunctional) heart.