RESUMO
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.
Assuntos
Humanos , Morte Fetal , Insuficiência Cardíaca , Mortalidade , Parto , Perfusão , Poli-Hidrâmnios , Doadores de Tecidos , Gêmeos Monozigóticos , Cordão Umbilical , ÚteroRESUMO
A 17-year-old primigravida, who had an elective abortion in the second trimester of pregnancy in a local clinic, was transferred to our hospital in state of status epilepticus. During the last 2-hr period immediately prior to admission the patient had an unknown number of generalized convulsions together with intermittent episodes of vomiting. Despite the administration of anticonvulsants and sedatives her condition was one of wild agitated response to stimuli, alternating with deep coma. After a tentative diagnosis of dilutional hyponatremia, she was given hypertonic saline solutions in addition to anticonvulsant therapy. Fourteen hours after her seizure, the patient was awake, alert, and cheerful but totally amnescent about the previous period. This case of severe water intoxication associated with an infusion of oxytocin reported here may serve as a reminder of the potential hazards of a widely used procedure, and of the precautions which must be observed.