Akardiyak İkiz: İki Farklı Olgu İki Farklı Prognoz

Akardiyak ikiz gebelik, monokoryonik ikiz gebeliklerin %1,46’sında izlenen nadir bir komplikasyondur 1 . Kalp ve genellikle üst ekstremite dahil gövdenin üst bölümü gelişmemiş olan ikiz eşi, sağlam görünümlü ikiz eşinin umbilikal arterinden aldığı bir anastomoz ile beslenir 2 . Çoğu zaman 1. trimester sonlarında tanı alabilen bu komplikasyonda, dolaşımlar arasındaki anastomotik bağlantı zamanında ayrılmaz ise pompa görevi gören sağlıklı ikiz eşi için mortalite %55’lere ulaştığı gibi preterm doğum gibi obstetrik sorunlar da artmaktadır 3 . Akardiyak ikiz eşi için mortalite kaçınılmazdır. Bu yüzden akardiyak ikiz eşinin dolaşımının durdurulması çoğu vakada sağlıklı görünen fetusun kaybı ve preterm doğum gibi sorunların önlenmesinde temel yaklaşımdır 3 . Bu olgu sunumunda 11. gebelik haftasında tanı alan ancak prognozu tamamı ile farklı olan 2 TRAP Twin Reversed Arterial Transfusion olgusu ve klinik yönetimlerini tartışmayı amaçladık

A-Cardiac Twin: Two Different Cases and Two Different Prognosis

A-cardiac twin pregnancy is a rare complication occurs in 1,46 %of all monochorionic twin pregnancies. The fetus whose heart and upper body haven’t been developed and the rest of the body has its blood supply from a branch of the umbilical artery can be considered a healthy fetus? . Usually the complication can be diagnosed in the end of 1st trimester and if the anastomosis of circulation isn’t separated on time, the mortality rate for the healthy fetus who has the blood pumper role will be 55 %. So the obstetric problems such as preterm delivery increase. The death for the fetus who has no heart is certain. Therefore, stopping the blood circulation of the fetus with cardiac abnormality is the main approach to prevent problems such as the lose of the healthy fetus and preterm delivery. We aim to discuss the clinical management of two cases which have been diagnosed with TRAP Twin Reversed Arterial Transfusion in their 11th week of gestation and have had totally different prognosis

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Acıbadem Üniversitesi Sağlık Bilimleri Dergisi-Cover
  • ISSN: 1309-470X
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2010
  • Yayıncı: ACIBADEM MEHMET ALİ AYDINLAR ÜNİVERSİTESİ