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June 1978

Hydrops Fetalis in a Parabiotic, Acardiac Twin

Author Affiliations

Neonatology Division Georgetown University School of Medicine Columbia Hospital for Women 2425 L St NW Washington, DC 22237

Am J Dis Child. 1978;132(6):638-639. doi:10.1001/archpedi.1978.02120310102026

The following infant was born with hydrops of unusual origin, the acardiac parabiotic twin syndrome.1 This case is presented to emphasize2,3 the importance of hypoproteinemia in the general pathophysiology of hydrops fetalis, regardless of etiology, and to note its presence in this rare instance.

Report of Cases.—Twin babies were born to a primigravida, Rh-positive, syphilisseronegative woman at 35 weeks' gestation. Three liters of clear fluid were notedat amniotomy performed during labor.

Twin A, a boy, was limp, pale, and had severe abdominal distention, and gross pitting edema of the scalp, abdomen, and extremities, ie, hydrops fetalis. The birth weight was 1,660 g. His Apgar scores were 2 and 3 at one and five minutes, respectively. Artificial ventilation by endotracheal tube was initiated. Thirty milliliters of 5% salt-poor albumin was given immediately in the delivery room because of hypotension and impaired systemic perfusion. The infant had pulmonary rales and a liver