Document Detail

From monster to twin reversed arterial perfusion: a history of acardiac twins.
MedLine Citation:
PMID:  20121538     Owner:  NLM     Status:  MEDLINE    
A human being born without heart and head, i.e., the acardius/acranius malformation, has been described since antiquity. Superstition and fear made it a mystical disorder, a sign of God's wrath. The inquisition ruled that acranic infants should not be baptized and located the soul in the brain. Acardia was not associated with twin gestation until the reports of Mery in 1720 and Winslow in 1740. In 1850, Meckel identified the pathogenetic mechanism as reversed perfusion due to large arterio-arterial and veno-venous anastomoses; he believed the heart would fail to develop or arrest during development, and the acardiac fetus would be maintained by arterial perfusion from the pump twin. In 1859, Claudius articulated that after normal initial development, the heart degenerates when reversed flow in the aorta leads to thrombosis. Today, it is assumed that both mechanisms may exist. With the advent of prenatal ultrasound diagnosis and radiofrequency ablation of the acardiac twin's circulation, it became possible to save the pump twin.
Michael Obladen
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Publication Detail:
Type:  Historical Article; Journal Article    
Journal Detail:
Title:  Journal of perinatal medicine     Volume:  38     ISSN:  1619-3997     ISO Abbreviation:  J Perinat Med     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-06     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0361031     Medline TA:  J Perinat Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  247-53     Citation Subset:  IM    
Department of Neonatology, Charit? University Medicine, Berlin, Germany.
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MeSH Terms
Fetofetal Transfusion / complications,  history*,  therapy
Head / abnormalities*
Heart Defects, Congenital / history*
History, 15th Century
History, 16th Century
History, 17th Century
History, 18th Century
History, 19th Century
History, 20th Century
History, Medieval
Infant, Newborn
Ultrasonography, Prenatal / history

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

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