Department of Gynecology and Obstetrics, Division of Prenatal Diagnosis and Therapy, University of Vienna, 1090 Vienna, Austria
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Abstract |
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Key words: acardius/trisomy 2/twin pregnancy/twin reversed arterial perfusion
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Introduction |
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The second case of acardiac twin pregnancy in which a cytogenetic investigation of the acardiac fetus resulting from trisomy 2 is presented.
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Case report |
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Labour was induced by prostaglandin 10 days after the due date. Because of fetal distress, Caesarean section was performed at 42 weeks gestation. A healthy girl with Apgar score 9/10/10 was delivered. The umbilical cord had three vessels, the birth weight was 2860 g, the length was 49 cm and the infant had no signs of decompensation. The acardiac twin with a single umbilical artery was delivered in a separate amniotic sac, together with the monochorionic placenta.
The acardiac twin is presented in Figure 1; the skeleton deformation on X-ray is presented in Figure 2
. Cytogenetic analysis by fetal skin culture of the acardiac twin showed the karyotype to be 47,XX,+2. Cytogenetic analysis by lymphocyte culture of the healthy co-twin showed 46,XX, of the 26 year old mother 46,XX, and of the 34 year old father 46,XY.
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Discussion |
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Chromosomal analysis of the acardiac twin presented here showed trisomy 2. Only a few abortions in the late first trimester have been reported and no case of trisomy 2 in which the fetus survived into the second trimester have been described (Kleinebrecht and Geisler, 1975). The principal perinatal problems associated with acardiac twinning such as pump-twin congestive heart failure, maternal hydramnios, and preterm delivery (Moore et al., 1990
) did not occur in our case, probably because of comparatively minor weight of the acardius. To evaluate the impact of aneuploidy in acardiac twin pregnancies, cytogenetic investigations should be carried out routinely.
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Notes |
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References |
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Submitted on August 5, 1999; accepted on October 22, 1999.