[Fetal therapy in utero by blockage of the umbilical blood flow of acardiac monster in twin pregnancy].

Abstract

We studied a life-saving method for the unaffected twin in two recent patients who had acardiac monster in twin pregnancy. We succeeded in blocking the umbilical blood flow of the acardiac monster in utero as radical treatment for this abnormality in one of the patients. In case 1, tocolysis and amniocentesis with puncture to the cyst of the acardiac monster were performed to prevent premature labor. However, the patient underwent premature labor at 27 weeks of gestation, and the newborn died. In case 2, fetal treatment was given: A steel coil was placed in the umbilical cord close to the abdominal wall of the acardiac monster under ultrasonographic guidance at 23 weeks of gestation to block blood flow. As a result, no enlargement of the acardiac monster was observed, and the cardiac function of the unaffected fetus improved. At 38 weeks of gestation, the patient delivered a normal baby weighing 2,237g and an acardiac monster weighing 110g. There were no complications in either the mother or newborn. There has been no report describing blockage of the umbilical blood flow of an acardiac monster in utero. Our method is considered efficient and less risky to the mother and the unaffected twin.