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Acardiac twins. Two case reports

M Pezzati¹, D Cianciulli, G Danesi

¹Department of Pediatrics, University of Firenze, School of Medicine, Italy.

Journal of Perinatal Medicine

|January 1, 1997

Summary

Acardiac twin syndrome, a rare complication in identical twin pregnancies, occurs due to abnormal blood vessel connections. Early ultrasound diagnosis and conservative therapy can improve outcomes for the surviving twin.

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Area of Science:

Perinatology
Maternal-Fetal Medicine
Twin Pregnancy Complications

Background:

Acardiac twin syndrome is a rare but severe complication of monochorionic twin pregnancies.
It arises from abnormal arterio-arterial and veno-venous anastomoses, leading to an acardiac twin with a fatal outcome.
The surviving twin often faces significant risks, including congestive heart failure, with perinatal mortality rates of 50-70%.

Observation:

Prenatal diagnosis of acardiac twin syndrome is feasible using ultrasound.
Two cases are presented where acardiac twin syndrome was diagnosed prenatally.
Both cases involved successful management through conservative therapeutic approaches.

Findings:

Conservative therapy can be effective in managing congestive heart failure in the pump twin.
Interruption of vascular communication between twins is a surgical option to preserve the pump twin.
Successful conservative management was achieved in the presented cases.

Implications:

Early and accurate prenatal diagnosis via ultrasound is crucial for acardiac twin syndrome.
Conservative management strategies may offer a viable alternative to surgical intervention in select cases.
Improved understanding and management of acardiac twin syndrome can potentially reduce perinatal mortality and morbidity.

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