Acardiac Acephalus Twin and Associated Anomalies: A Case Report

A 30-year-old multipara was found to carry an acardiac acephalus twin in a monozygotic twin pregnancy at 24 weeks of gestation and was referred to us from a private clinic. A cardiac twinning, a rare congenital anomaly of monozygotic twin pregnancy, often results from abnormal placental vascular anastomosis. Acardiac acephalus is a acardiac twin lacking a head, though it may have arms; thoracic organs are generally absent, and disorganized & unidentifiable tissues take their place, which invariably leads to death of the "perfused" twin and an estimated 50% perinatal mortality rate in the "pump" twin, due mainly to premature delivery or congestive heart failure. Autopsy of the fetus showed abnormalities compatible with the maldevelopment of embryonic folding. Fetus had omphalocele, bilateral absent kidneys, dextrocardia, hypoplastic lungs, absent right radial bone, abnormally positioned ears and agnathia.