Hostname: page-component-77f85d65b8-7lfxl Total loading time: 0 Render date: 2026-04-15T00:57:48.359Z Has data issue: false hasContentIssue false
  • English
  • Français

The Holoacardius: A Correlative Computerized Tomographic, Radiologic, and Ultrasonographic Investigation of a New Case with Review of Literature

Published online by Cambridge University Press:  01 August 2014

K.P. Bhatnagar ,
S.C. Sharma  and
J. Bisker
K.P. Bhatnagar*
Affiliation:
Departments of Anatomy, Radiation Oncology, and Diagnostic Radiology, University of Louisville, School of Medicine, Kentucky
S.C. Sharma
Affiliation:
Departments of Anatomy, Radiation Oncology, and Diagnostic Radiology, University of Louisville, School of Medicine, Kentucky
J. Bisker
Affiliation:
Departments of Anatomy, Radiation Oncology, and Diagnostic Radiology, University of Louisville, School of Medicine, Kentucky
*
Department of Anatomy, University of Louisville School of Medicine, Louisville, KY 40292, USA

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the 'Save PDF' action button.

A holoacardius from a monozygotic, monochorionic twin pregnancy of 36 weeks is described. Trisomy-18 was diagnosed in the viable female cotwin. Computerized tomographic, radiologic, and ultrasonographic procedures were applied to the acardiac. Its three-vessel umbilical cord was velamentously attached to the single placenta. Grossly malformed and poorly developed craniofacial structures, absence of neck and upper extremities, sirenomelic lower extremity, absence of heart, and development of only a few skeletal elements were prominent features. A review of selected world literature emphasizes the limits of the estimates dealing with the total number of reported cases and the incidence of acardii.

Keywords

AcardiusComputerized tomographyMonozygotic twin pregnancyUltrasound

Information

Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 35 , Issue 1-2 , April 1986 , pp. 77 - 89
Copyright
Copyright © The International Society for Twin Studies 1986

References

REFERENCES

1. Alderman, B (1973): Foetus acardius amorphus. Postgrad Med J 49:102–105.Google Scholar
2. Averback, P, Wiglesworth, FW (1978): Congenital absence of the heart: observation of human funiculopagus twinning with insertio funiculi furcata, fusion, forking, and interposito velamentosa. Teratology 17:143–150.CrossRefGoogle Scholar
3. Benedetti, A (1533): De Morborum a Capite ad Pedis Signis, Habes Lector Studiose Hoc Volumine. (Quoted by Simonds and Gowen, 1925).Google Scholar
4. Bieber, FR, Nance, WE, Morton, CC, Brown, JA, Redwine, FO, Jordan, RL, Mohanakumar, T (1981): Genetic studies of an acardiac monster: evidence of polar body twinning in man. Science 213:775–777.Google Scholar
5. Bulmer MG (1970): The Biology of Twinning in Man. Oxford: Clarendon Press.Google Scholar
6. Corner, EM (1901): Acardiac monster caused by a foetal adhesion to a placenta succenturiata. J Anat 36:81–92.Google ScholarPubMed
7. Das, K (1902): Acardiacus anceps. J Obstet Gynecol Brit Emp 2:341–355.CrossRefGoogle Scholar
8. Deacon, JS, Machin, GA, Martin, JME, Nicholson, S, Nwankwo, DC, Wintemute, R (1980): Investigation of acephalus. Am J Med Genet 5:85–99.CrossRefGoogle ScholarPubMed
9. Dicker, D, Pelag, D, Samuel, N, Feldberg, D, Goldman, JA (1983): Holoacardius: radiological investigation. Early Human Develop 9:59–65.CrossRefGoogle Scholar
10. Frutiger, P (1969): Zum Problem der Akardie. Acta Anat 74:505–531.CrossRefGoogle Scholar
11. Gillim, DL, Hendricks, CH (1953): Holoacardius: review of the literature and case report. Obstet Gynecol 2:647–653.Google ScholarPubMed
12. Guttmacher, AF (1939): Clinical aspects of twin pregnancy. Med Clin N America 23:427–447.Google Scholar
13. Guttmacher, AF, Kohl, SG (1958): The fetus of multiple gestations. Obstet Gynecol 12:528–541.Google ScholarPubMed
14. James, WH (1977): A note on the epidemiology of acardiac monsters. Teratology 16:211–216.CrossRefGoogle ScholarPubMed
15. Kaplan, C, Benirschke, K (1979): The acardiac anomaly: new case reports and current status. Acta Genet Med Gemellol 28:51–59.Google ScholarPubMed
16. Kappelman, MD (1944): Acardius amorphus. Am J Obstet Gynecol 47:412–416.Google Scholar
17. Kaufman, MS, Walters, D (1957): Acardius: report of a case. Obstet Gynecol 9:221–223.Google Scholar
18. Lachman, R, McNabb, M, Furmanski, M, Karp, L (1980): The acardiac monster. Eur J Pediatr 134:195–200.Google Scholar
19. Mantoni, M, Pederson JF (1980): Monoamniotic twins diagnosed by ultrasound in the first trimester. Acta Obstet Gynecol Scand 59:551–553.Google Scholar
20. Napolitani, FD, Schreiber, I (1960): The acardiac monster. A review of the world literature and presentation of 2 cases. Am J Obstet Gynecol 80:582–589.CrossRefGoogle Scholar
21. Nishimura, H, Okamoto, N (eds) (1976): Sequential atlas of human congenital malformations. Baltimore: University Park Press.Google Scholar
22. Pal, SK, Saha, PK (1981): Paracephalic acardiac monster. J Indian Med Assoc 76:18–19.Google ScholarPubMed
23. Richart, R, Benirschke, K (1963): Holoacardius amorphus: report of a case with chromosome analysis. Am J Obstet Gynecol 86:329–332.Google Scholar
24. Rydnert, J, Holmgren, G, Sigurd, J (1984): Intra-uterine diagnosis of an acardiac monster. Acta Obstet Gynecol Scand 63:569–570.Google Scholar
25. Sarma, V (1960): Holoacardius monster in obstetrics. Brit J Clin Prac 14:795–800.CrossRefGoogle Scholar
26. Sato, T, Kaneko, K, Konuma, S, Sato, I, Tamada, T (1984): Acardiac anomalies: review of 88 cases in Japan. Asia Oceania J Obstet Gynaecol 10:45–52.CrossRefGoogle ScholarPubMed
27. Scott, JM, Ferguson-Smith, MA (1973): Heterokaryotypic monozygotic twins and the acardiac monster. J Obstet Gynecol Br Commonw 80:52–59.CrossRefGoogle ScholarPubMed
28. Simonds, JP, Gowan, GA (1925): Fetus amorphus: report of a case. Surg Gynecol Obstet 41: 171–179.Google Scholar
29. Simpson, PC, Trudinger, BJ, Walker, A, Baird, PJ (1983): The intrauterine treatment of fetal cardiac failure in a twin pregnancy with an acardiac acephalic monster. Am J Obstet Gynecol 147:842–844.Google Scholar
30. Stephens, TD (1984): Muscle abnormalities associated with the twin reversed-arterial-perfusion (TRAP) sequence (Acardia). Teratology 30:311–318.Google Scholar
31. Strassman, E (1931): Monocuniculare Zwillinge bei Placenta Praevia. Zentralbl Gynaekol 55:46 (cited in Kappelman, 1944).Google Scholar
32. Wexler, S, Baruch, A, Ekshtein, N, Libal, Y, Yedwab, G, Ornoy, A, (1985): An acardiac acephalic anomaly detected on sonography. Acta Obstet Gynecol Scand 64:93–94.CrossRefGoogle ScholarPubMed
33. Wilson, EA (1972): Holoacardius. Obstet Gynecol 40:740–748.Google ScholarPubMed
34. Van Allen, MI (1981): Fetal vascular disruptions: mechanisms and some resulting birth defects. Pediatr Ann 10:219–233.Google ScholarPubMed
35. Van Allen, MI, Smith, DW, Shepard, TH (1983): Twin reversed arterial perfusion (TRAP) sequence: a study of 14 twin pregnancies with acardius. Seminars in Perinatology 7:285–293.Google Scholar
36. Yoshihara, H, Maisel, H (1973): An acardiac human fetus. Anat Rec 177:209–218.Google Scholar