A Case of Acardiac Twin / 대한주산의학회잡지

The acardiac twin is very rare congenital malformation of monozygotic multiple gestations affecting 1% of monozygotic twins, or 1 in 35000 births. The acardiac twin has a parasitic existence and depends on the donor twin for its blood supply via placental anastomoses and retrograde perfusion of the acardiac umbilical cord. Acardiac twin places the normal twin at risk for high output cardiac failure and in utero fetal death and may lead to polyhydramnios and its related complications. The mortality rate is reported to be between 50% and 75% for the normal twin. We recently experienced a case of acadius anceps with a normal twin death in uterus, so present with a brief review of the literature.

Panhypopituitarism in a Pregnant Woman with Ovarian Hyperstimulation Syndrome and Residual Pituitary Adenoma / 대한산부인과학회잡지

Ovarian hyperstimulation syndrome (OHSS) is one of the most serious complication of controlled ovarian hyperstimulation (COH) and ovulation induction. High serum estradiol concentration can induce the increase of capillary permeability and fluid shift, and it can results in hypovolemia, hemoconcetration, thromboembolism, oliguria, ascites and even death. This physiologic changes of OHSS and/or pregnancy might induce the deterioration of pituitary function in patients with abnormal pituitary conditions such as low pituitary reserve or tumor. However, all this while, panhypopituitarism or pituitary apoplexy in a pregnant woman with OHSS and/or pituitary adenoma has not been reported. We have experienced a case of panhypopituitarism developed in a pregnant woman with severe OHSS and residual pituitary adenoma. She had residual prolactinoma, despite a transsphenoidal adenoidectomy, and had suffered from uncontrolled hyperprolactinemia (HPRL) and chronic anovulation. Therefore, she had taken ovulation induction for getting a pregnancy and conceived, but, in the conception cycle, she was hospitalized for management of severe OHSS and hyperemesis gravidarum. During the period of hospitalization, abrupt panhypopituitarism was developed unexpectedly. Therefore, we present this case with the brief review of literature.