Fetal acardia in monochorionic-diamniotic twin pregnancy

Abstract

Objective: Report the case of a patient with monochorionic and diamniotic pregnancy, diagnosed with an acardiac fetus, treated in a city in the interior of São Paulo, scientifically reviewing the subject, including clinical presentation, diagnosis and therapy. Case detail: Female patient, 19 years old, healthy, low maternal weight, no relevant family history, second-pregnant with a previous spontaneous abortion, resident in the interior of São Paulo. She was diagnosed with monochorionic diamniotic twins and, later, with reverse twin arterial perfusion sequence and, consequently, fetal malformation because an acardiac fetus. The pregnancy was monitored in high-risk prenatal care and the resolution occurred at 33 weeks of gestation due to preterm labor. It gave rise to an acardiac fetus, dead, and another fetus without malformations, referred to the care of pediatrics. Final considerations: Acardiac pregnancy is a rare phenomenon that occurs in 1% of monochorionic twin pregnancies. Due to the vascular alterations of TRAPS, the donor fetus may present a reduction in circulating blood volume and increased cardiac effort. Early ultrasound plays a crucial function in the diagnosis and monitoring of these conditions, allowing timely interventions when necessary.