Acardiac twin with preserved brain

The fatal acardiac syndrome is a rare complication of monochorionic twinnin g and is reported in 1 of 35,000 births. It is caused by arterioarterial an d venovenous placental anastomoses leading to circulatory predominance of 1 twin, The donor 'pump' twin provides circulation for itself and for the re cipient acardiac twin. The acardiac twin is usually grossly abnormal with s evere reduction anomalies of the upper part of the body. We report a twin p regnancy, where a recipient twin initially by ultrasound was misdiagnosed a s dead. In the third trimester the supposedly dead twin presented as an ede matous acardiac twin without peripheral reduction defects and a nearly norm ally developed brain, An acardiac twin with a nearly normal external appear ance and an almost normally developed brain, nourished by a surviving twin brother, has not previously been described in the literature, Copyright (C) 2001 S. Karger AG. Basel.