Acardiac twins — case report

The acardius syndrome is a rare complication of monochorionic twin gestation, occuring In 1: 35000 pregnancies. It is caused by abnormal arterioarterial venovenous placental anastomoses leading to circulatory predominance and even insufficiency of one twin (pump twin) and mortal anomalies the acardiac twin. Acardiac twins gestation is at increased risk of polyhydramnios and preterm delivery. This severe pathology may be treated by different approaches to interrupt abnormal vascular communications or by serial amniocenteses to decompress the polyhydramnios.
We present a case of 31-year-old women directed to our hospital for evaluation of suspected polyhydramnios. On admissional ultrasound examination we recognized acardiac twins gestation complicated by polyhydramnios of amniotic sac of pump twin. Serial amniocenteses were done to decompress the polyhydramnios during few weeks hospitalization. Because of symptoms of severe overload of circulatory of pump twin cesarean section in 30 week of pregnancy was decided. Alive female infant
weighing 1570 g and an acardiac fetus with multiple malformations of the body weighing 1600 g without sings of life was delivered. On account of circulatory insufficiency and significant prematurity the alive twin required prolonged treatment and rehabilitation to this times.
The option of conservative method can be still an effective treatment alternative to various more and more often used surgical methods of management.