Key result
Fetal acardia is a rare lethal anomaly in monozygotic twins with perinatal mortality for the normal twin reported to be as high as 50%, requiring serial monitoring and potential in utero treatment.
Fetal acardia is a rare anomaly in monozygotic twins that carries up to a 50% mortality risk for the normal co-twin, necessitating serial sonographic and Doppler monitoring.
SummaryAcardiac malformation is a rare lethal anomaly in one of monozygotic twins that occurs in approximately 1 in 34000 pregnancies. Although the aetiology remains unknown, two main theories have been proposed: (1) a chromosomal defect causing failure of development of cardiac and other tissues; (2) arrest of normal cardiac development secondary to circulatory reversal in the affected twin. The survival of the affected acardiac twin in utero depends on blood supply from its normal co-twin. The perinatal mortality for the normal twin has been reported to be as high as 50 per cent. The cause of death is usually prematurity or congestive heart failure. Fetal monitoring of the normal twin should include serial high resolution sonography and Doppler blood flow studies. With signs of fetal compromise, delivery is usually recommended. Alternatively, in utero treatment of heart failure may be advantageous at pre-viable gestational ages.
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Nicolaidis et al. (1990) conducted a review in Fetal acardia. Fetal acardia was evaluated on Perinatal mortality for the normal twin. Fetal acardia is a rare lethal anomaly in monozygotic twins with perinatal mortality for the normal twin reported to be as high as 50%, requiring serial monitoring and potential in utero treatment.
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