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      Acardia fetal en embarazo triple. Reporte de un caso

      case-report

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          Abstract

          RESUMEN: Se presenta el caso de una primigesta de 24 años de edad, con diagnóstico por ultrasonografía transvaginal de 3 sacos embrionarios, de los cuales 2 presentaban actividad cardíaca y un tercero sin ella. Posteriores controles no permitieron visualizar un saco, por lo cual se concluyó que se trataba de un embarazo triple, con uno de los fetos evanescentes. El embarazo evoluciona de forma tórpida, hasta la expulsión de 2 recién nacidos femeninos en malas condiciones, y una masa de tejido amorfa.

          Translated abstract

          SUMMARY: The case of a 24 year-old primigravida is presented, with diagnosis for transvaginal ultrasonographic of 3 embryonic sacks, of which 2 presented heart activity and a third without her. Later controls didn’t allow to visualize a sack, reason why you concluded that it was about a triple pregnancy, with one of the evanescent fetuses. The pregnancy evolves in a torpid way, until the feminine recently born expulsion of 2 in bad conditions, and an amorphous fabric mass.

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          Most cited references16

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          Perinatal outcome of forty-nine pregnancies complicated by acardiac twinning.

          Acardiac twinning affects 1 in 100 monozygotic twin pregnancies and 1 in 35,000 pregnancies overall. The presence of an acadiac twin requires the normal (or "pump") twin to provide circulation for itself, as well as the acardiac sibling. In many cases the acardiac twin is almost equal to the normal twin. The principal perinatal problems associated with acardiac twinning are pump-twin congestive heart failure, maternal hydramnios, and preterm delivery. We reviewed the perinatal courses of 49 acardiac twin pregnancies to identify factors prognostic of favorable outcome. The overall perinatal mortality was 55%, primarily associated with prematurity. Mean (+/- SD) gestational age at delivery was 29 +/- 7.3 weeks, with a mean (+/- SD) normal twin weight of 1378 +/- 1047 gm. The acardiac weight averaged 651 +/- 571 gm. However, the occurrence of hydramnios, the occurrence of preterm labor, and perinatal outcome were strongly related to the ratio of the acardiac and pump-twin's weight. The mean overall ratio of the twin weights was 52% +/- 42%. However, the mean weight ratio for patients delivered before 34 weeks was 60% versus 29% (p less than 0.04). Preterm delivery was strongly associated with the development of hydramnios and congestive heart failure in the pump twin (p less than 0.01). If the twin-weight ratio was above 70% (25% of cases), the incidence of preterm delivery was 90%; hydramnios, 40%; and pump-twin congestive heart failure, 30% compared with 75%, 30%, and 10%, respectively, when the ratio was less (p less than 0.05). Regression of the weight of the acardiac twin against its longest dimension (L) resulted in this equation for prediction of acardiac weight: Weight (grams) = 1.2 L2-1.7L; r = 0.79, p less than 0.01. These data suggest that estimation of the relative weights in acardiac twins provides prognostic information regarding outcome. Poor outcome occurs with congestive heart failure and hydramnios in the normal twin. Use of the above data may assist in counseling patients and determining optimal management.
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            Ultrasonografia y clínica embrio-fetal.

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              Ultrasonografía y Clínica Embrio Fetal

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                og
                Revista de Obstetricia y Ginecología de Venezuela
                Rev Obstet Ginecol Venez
                Sociedad de Obstetricia y Ginecología de Venezuela (Caracas )
                0048-7732
                September 2002
                : 62
                : 3
                : 203-206
                Affiliations
                [1 ] Universidad del Zulia
                Article
                S0048-77322002000300006
                b09495fa-4431-449d-ac13-d69648059e24

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0048-7732&lng=en
                Categories
                OBSTETRICS & GYNECOLOGY

                Obstetrics & Gynecology
                Fetal acardia,Triple pregnancy,Acardia fetal,Embarazo triple
                Obstetrics & Gynecology
                Fetal acardia, Triple pregnancy, Acardia fetal, Embarazo triple

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