* Department of Gynecology, Félix Guyon Hospital, 97400 Saint-Denis, Ile de la Réunion, France;
** Gynecologist, Chaussee"s Street, 97420 Saint-Paul, Ile de la Réunion, France;
*** Department of anatomopatholy, Félix Guyon Hospital, 97400 Saint-Denis, Ile de la Réunion, France.
Case report
A 38-year-old woman (G1P0), with non-contributive family history, was referred to our antenatal unit at 27 weeks of pregnancy due to an abnormal mass of the placenta. The amount of amniotic fluid was normal and fetal growth was in normal limits. Her first trimester sonography and triple test were normal.
The exam demonstrated:
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The "abnormal mass of the placenta" actually had a central arterial pulsation with a peripheral venous flow and turned out to be an acardiac fetus in a monochorionic, monoamniotic twin pregnancy;
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The umbilical cord of the acardiac fetus was near the cord of the normal fetus, but independent;
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The morphology of the normal fetus was without anomalies except for the dilatation of the abdominal course of the umbilical vein.
The patient refused umbilical cord embolization of the acardiac twin. An amniocentesis was done, revealing normal karyotype (46,XX). The size of the acardiac twin stayed the same during the follow-up examinations, but the normal twin developed signs of cardiac decompensation at 34 weeks, and the pregnancy was terminated by a cesarean section. The normal neonate weighted 2000 g and its postnatal adaptation was without complications. The acardiac twin was without recognizable organs and was described as an acardiac amorphus twin.
Images 1, 2: The image 1 shows the placenta (left part of the image) and transverse scan of the acardiac twin (right part of the image). The image 2 shows a mass of the acardiac twin imitating a mass arising from the placenta.