Triplet pregnancy complicated by intrauterine fetal death of conjoined twins from an umbilical cord accident of an acardius. A case report.
BACKGROUND: Acardius is a rare occurrence in monozygotic multiple pregnancies. Triplet pregnancy composed of an acardiac fetus and a pair of conjoined twins is even more rare. The outcome of the acardius is invariably fatal, and the mortality rate of the other fetuses ranges between 50% and 70%. Perinatal mortality results mainly from complications of twin-twin transfusion syndrome. CASE: Intrauterine fetal death, caused by an umbilical cord accident, with twisting of the acardius's cord around the fused cords of conjoined twins is reported in this present work. CONCLUSION: An acardius should be thoroughly sought when monochorionic multiple pregnancies are found by ultrasound during prenatal care. The complications of pregnancy caused by an acardiac fetus can be avoided by using proper management.