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Korean Journal of Obstetrics & Gynecology 2001;44(8):1534-1539.
Published online August 1, 2001.
A case of acardiac twin with conservative management.
Joong Yeup Lee, Soon Sup Shim, Soo Yeon Han, Eun Mi Ko, Joong Shin Park, Jong Kwan Jun, Bo Hyun Yoon, Hee Chul Syn
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Acardiac twin is a rare complication of multifetal pregnancy. The literatures report an incidence of 1% among monochorionic twin pregnancies, i. e. 1 of 35,000 pregnancies. The absence of identifiable fetal heart structures in one twin and reduction anomalies in many organ systems suggest the diagnosis. It has been hypothesized that in the presence of artery-to-artery and vein-to-vein anastomoses in a monozygotic placenta, blood is perfused by hemodynamically advantaged pump-twin to the recipient twin by retrograde flow. The principal perinatal problems associated with acardiac twinning are congestive heart failure of pump-twin, maternal polyhydramnios, preterm delivery and intrauterine death. The outcome is invariably fatal for the acardiac twin and 50-75% of the normal twin. Management options include observation, medical therapy, and selective termination of acardiac twin. The most appropriate intervention for the various clinical presentations of this disorder is undetermined, and conservative nonintervention is often appropriate. Long-term follow-up data on surviving pump twins are lacking. We experienced a case of acardiac twin gestation which showed satisfactory outcome with conservative management, so we present the case with a brief review of the literature.
Key Words: Acardiac twin, Conservative management

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