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Acardius anceps with neck cyst and cleft palate: Three dimensional skeletal computed tomography reconstruction with discussion of the literature.
Birth Defects Research ( IF 1.6 ) Pub Date : 2019-11-27 , DOI: 10.1002/bdr2.1625
Martin J C van Gemert 1 , Geert J Streekstra 1 , Frank P H A Vandenbussche 2 , Peter G J Nikkels 3 , Jeroen P H M van den Wijngaard 4
Affiliation  

Acardiac twinning is a rare anomaly of monochorionic twin pregnancies. Acardiac fetuses lack a functional heart but are passively perfused by arterial blood from their pump co‐twin causing the acardiac body to be hypoxemic. In this report, we present an acardius anceps, therapeutically laser separated from its pump twin at 16 weeks. The healthy pump twin and macerated acardiac body were born at 40 3/7 weeks. A three dimensional (3D) reconstruction was made by CT images, showing cranial bones, spinal column, pelvis and lower extremities but absent arms. A cyst in the neck of the acardiac twin was identified by postnatal sonography; this was also described in four literature cases, and was additionally observed by us in two other acardiac twins. Median cleft palate was identified by oral cavity inspection but undetectable in the reconstruction. In the literature, we found 21 other acardiac anceps twins with a cleft palate. From the two larger published series, with 12 clefts in 21 acardiac anceps twins, a cleft palate occurs in over 50% during acardiac twinning. Our first hypothesis is that acardiac fetuses develop an oral cleft palate when acardiac onset starts prior to 11 weeks, because 11 weeks includes the period of embryonic oral cavity formation, and no cleft occurs when onset starts later than 11 weeks. Our second hypothesis is that cysts and cleft palates are more common in acardiac twins than currently known, likely reflecting that acardiac bodies are hypoxemic and that hypoxia contributes to the development of both cysts and clefts.

中文翻译:

患有颈部囊肿和c裂的无心搏动性脚印:三维骨骼计算机体层摄影术重建,并进行文献讨论。

无心胎孪生是单绒毛膜双胎妊娠的罕见异常。心律失常的胎儿缺乏功能性心脏,但被其泵浦双生子的动脉血被动灌注,导致心律失常的身体缺氧。在本报告中,我们介绍了一种无心ance子,在治疗第16周时从其泵浦双胞胎中进行激光分离。健康的双胞胎和浸没的无心cardi体在40 3/7周出生。通过CT图像进行三维(3D)重建,显示颅骨,脊柱,骨盆和下肢,但没有手臂。产后超声检查发现心律失常双胞胎的颈部有一个囊肿。在四个文献案例中也对此进行了描述,并且在另外两个无心双胞胎中也被我们观察到。oral裂中位通过口腔检查确定,但在重建中无法检测到。在文献中,我们发现了另外21例双心ance裂双胞胎伴pa裂。在两个较大的已发表系列文章中,在21个无心双胞胎双胞胎中有12个裂痕,在无心双胞胎孪生期间,裂over发生率超过50%。我们的第一个假设是,无心胎胎儿在11周前开始无心胎时会出现口腔c裂,因为11周包括胚胎口腔形成的时期,而在11周后开始发作时就不会发生c裂。我们的第二个假设是,无囊双胞胎中的囊肿和c裂比目前已知的更为常见,这可能反映出无囊体是低氧血症,缺氧导致囊肿和裂隙的发展。在21例无心搏动双胞胎中,有12例裂口,在无心动胎孪生期间发生裂over的发生率超过50%。我们的第一个假设是,无心胎胎儿在11周前开始无心胎时会出现口腔c裂,因为11周包括胚胎口腔形成的时期,而在11周后开始发作时就不会发生c裂。我们的第二个假设是,无囊双胞胎中的囊肿和c裂比目前已知的更为常见,这可能反映出无囊体是低氧血症,缺氧导致囊肿和裂隙的发展。在21例无心搏动双胞胎中,有12例裂口,在无心动胎孪生期间发生裂over的发生率超过50%。我们的第一个假设是,无心胎胎儿在11周前开始无心胎时会出现口腔c裂,因为11周包括胚胎口腔形成的时期,而在11周后开始发作时就不会发生c裂。我们的第二个假设是,无囊双胞胎中的囊肿和c裂比目前已知的更为常见,这可能反映出无囊体是低氧血症,缺氧导致囊肿和裂隙的发展。发病时间晚于11周,则不会出现c裂。我们的第二个假设是,无囊双胞胎中的囊肿和c裂比目前已知的更为常见,这可能反映出无囊体是低氧血症,缺氧导致囊肿和裂隙的发展。发病时间晚于11周,则不会出现c裂。我们的第二个假设是,无囊双胞胎中的囊肿和c裂比目前已知的更为常见,这可能反映出无囊体是低氧血症,缺氧导致囊肿和裂隙的发展。
更新日期:2019-11-27
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