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[Acardiac twins]

C Pinet1, J C Colau, A L Delezoide

  • 1Service de Gynécologie-Obstétrique, CMC Foch, Suresnes.

Journal De Gynecologie, Obstetrique Et Biologie De La Reproduction
|January 1, 1994
PubMed
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Acardiac twin, a rare complication in identical twin pregnancies, occurs due to abnormal blood vessel connections. This condition often leads to poor outcomes, necessitating early diagnosis and intervention.

Area of Science:

  • Perinatology
  • Reproductive Medicine
  • Developmental Biology

Background:

  • Acardiac twin is a rare complication specific to monozygotic (identical) multiple pregnancies.
  • It arises from abnormal vascular connections (arterio-arterial and veno-venous anastomoses) between the twins.
  • These connections lead to a hemodynamic imbalance, favoring one twin and compromising the other.

Observation:

  • The dominated acardiac twin develops severe morphologic malformations, including the absence of a heart.
  • The pregnancy is often complicated by fetal heart failure, hydramnios (excess amniotic fluid), and premature delivery in the healthy twin.
  • Outcomes are frequently unfavorable, with approximately 50% of pregnancies resulting in fetal or neonatal loss.

Findings:

  • Antenatal diagnosis is primarily achieved through ultrasound (echography).

Related Experiment Videos

  • Ultrasound evaluation of the acardiac twin's growth is crucial for assessing pregnancy prognosis.
  • The severity of the acardiac twin's malformations correlates with the risk to the healthy twin and overall pregnancy outcome.

    • Implications:

    • Current management strategies include treating the healthy twin's heart failure or surgically interrupting the vascular supply to the acardiac twin.
    • Early and accurate antenatal diagnosis is vital for timely intervention and improved pregnancy management.
    • Understanding the pathophysiology of acardiac twins can inform strategies to mitigate risks in high-risk multiple gestations.