Document Detail


Acardiac fetus complicating a triplet pregnancy: management and outcome.
MedLine Citation:
PMID:  19449324     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report our experience with the management of triplet pregnancies complicated by an acardiac fetus. METHODS: During the 5-year period from 2003 to 2008, five cases were identified. The prenatal sonographic findings, antepartum course, antenatal intervention if performed, and perinatal outcome of each case were reviewed. RESULTS: Four pregnancies were spontaneously conceived and one was achieved by in vitro fertilization. Three pregnancies were dichorionic and two were monochorionic, and two acardiac fetuses were part of a monoamniotic set. All cases underwent an early sonographic examination, but the diagnosis was only made in the first trimester in only two cases, as the acardiac fetus was overlooked or inaccurately identified as a dead fetus in the remaining three cases. Early fetal demise before 12 weeks occurred in a case of monochorionic-triamniotic triplets. Percutaneous laser coagulation of the main intra-abdominal vessel was attempted at 17 weeks in two cases, with subsequent delivery after 34 weeks and perinatal survival of three of the four structurally normal fetuses. In the other two pregnancies which were managed expectantly, both were complicated by severe preterm delivery with perinatal survival of three of the four structurally normal fetuses. Overall, there were no survivors in one case, one twin survived in two cases, and two twins survived in the remaining two cases. None of the survivor had neurological sequelae. CONCLUSIONS: The presence of an acardiac fetus in a triplet pregnancy carries a high risk for poor pregnancy outcome, including fetal death and severe preterm labor. Prenatal intervention may be indicated in some cases, but does not prevent fetal death of the pump twin.
Authors:
Waldo Sepulveda; Amy E Wong; Juan C Bustos; Ximena Flores; Juan L Alcalde
Related Documents :
11762154 - Pregnancy prolongation in triplet pregnancies. oral vs. continuous subcutaneous terbuta...
8894634 - Conservative treatment after miscarriage of one fetus in multifetal pregnancies. report...
3451644 - The recent trends in multiple births and stillbirth rates in japan.
8910784 - Selective reduction of pregnancy: a legal analysis.
15914344 - Umbilical artery doppler and umbilical cord ph at birth in small-for-gestational-age fe...
3141104 - The significance of anti-c sensitization in pregnancy.
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  29     ISSN:  1097-0223     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-30     Completed Date:  2009-10-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  794-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Fetal Medicine Center, Clinica Las Condes, Casilla 208, Santiago 20, Chile. fetalmed@yahoo.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple / embryology*,  pathology,  ultrasonography
Adult
Female
Fetal Death
Fetal Heart / abnormalities*
Fetofetal Transfusion / pathology,  surgery
Heart Defects, Congenital / embryology*,  pathology,  ultrasonography
Humans
Obstetric Labor, Premature
Pregnancy
Pregnancy Complications*
Triplets*
Ultrasonography, Prenatal

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Synthesis and Biological Characterization of (3R,4R)-4-(2-(Benzhydryloxy)ethyl)-1-((R)-2-hydroxy-2-p...
Next Document:  Thalamo-frontal white matter alterations in chronic schizophrenia: a quantitative diffusion tractogr...