Acardiac twinning: High resolution three-dimensional reconstruction of a low resistance case
| Autor: | Enrico Lopriore, Martin J. C. van Gemert, Geert J. Streekstra, Frank P.H.A. Vandenbussche, Jeroen P. H. M. van den Wijngaard, Maria Siebes, Peter G.J. Nikkels, Monique G. J. T. B. van Lier, Dick Oepkes |
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| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
Embryology medicine.medical_specialty High resolution Umbilical artery General Medicine Anatomy 030105 genetics & heredity Biology 03 medical and health sciences medicine.anatomical_structure Acardiac twin Internal medicine medicine.artery Pediatrics Perinatology and Child Health Circulatory system medicine Cardiology Arterial blood Vein Crystal twinning Perfusion Developmental Biology |
| Zdroj: | Birth Defects Research Part A: Clinical and Molecular Teratology. 106:213-217 |
| ISSN: | 1542-0752 |
| DOI: | 10.1002/bdra.23477 |
| Popis: | Background Acardiac twinning is a rare anomaly of monochorionic twin pregnancies. Acardiac fetuses lack a functional heart but are passively perfused by arterial blood from their pump co-twin. Although four acardiac morphological types have been classified, the various paths of anatomical and circulatory acardiac twin development, and the potential influence of acardiac size and perfusion flow as possible predictors of pump twin morbidity and mortality are poorly understood. This report presents the first high resolution three-dimensional reconstruction of the vasculature of an acardiac twin by cryomicrotome imaging. Case A small, approximately 7.5-cm-diameter ball-shaped acardius amorphous of 30 5/7 weeks had caused pump twin cardiac decompensation that necessitated an emergency cesarian section. The pump twin survived well. The acardiac body had a partially intact vascular system with large diameter arteries and veins and multiple zones that appeared devoid of perfusion. The three-dimensional reconstruction showed neither recognizable organ structures nor identifiable blood vessels except for the umbilical artery and vein. Conclusion Our case showed a small acardiac mass with large diameter vessels and consequential low outflow resistance that caused pump twin complications. This indicates that the development of a method that allows pump twin prognosis is likely more successful if based on the use of acardiac versus pump twin perfusion flows than on body volume ratios. Birth Defects Research (Part A) 106:213–217, 2016. © 2015 Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
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