Akardiyak ikizin konservatif yönetimi: Olgu sunumu

Akardiyak ikiz gebelik monokoryonik ikiz gebeliklerin % 1 inde ortaya çıkan nadir bir malformasyondur. Akardiak ikizlik, sıklıkla anormal plasental vasküler anastomozların sonucu ortaya çıkar. Bu durum daima alıcı ikiz için ölümcüldür ve pompa ikiz için yüksek mortalite oranı taşır. Pompa ikiz tipik şekilde yapısal olarak normaldir, fakat gebelik süresince kardiyomegali, perikardiyal ve plevral efüzyon, asit ve polihidramniyos ile birlikte kalp yetmezliği gelişebilir. Akardiyak ikiz gebeliklerin optimal yönetimi tartışmalıdır. Tedavinin cerrahi amacı pompa ikize zarar vermeden akardiyak ikize olan kan akımını kesmektir. Biz onaltıncı gebelik haftasında tanı konulan konservatif gözlem ile başarılı neonatal sonuçları olan akardiyak asefalik monokoryonik ikiz olgusu sunduk. Kötü prognostik faktörlerin olmadığı durumlarda konservatif yönetim daha iyi bir strateji olabilir.

Conservative management of acardiac twins: A case report

Acardiac twin is a seldom malformation monocorionic pregnancies with prevalance of 1%. Acardiac twin usually occurs due to abnormal placental vascular anastomosis. This anomally is always lethal for recipient and has high mortality for pump twin. Pump twin is structurely normal but heart failure may develop with cardiomegaly, pericardial and ğleural effusion, ascites and polyhidramnios during pregnancy. The optimal management of acardiac twin is controversial. The aim of the surgery is to cut the blood flow to acardiac twin without harming the pump twin. We presented an acardiac ancephalic monocorionic twin case that is diagnosed at 16th weeks of pregnancy and succesful neonatal result with conservative approach. Conservative approaches may be better in the absence of poor prognostic factors.

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