[Prenatal and postnatal cardiologic evaluation of normal twin from acardiac twin pregnancy--case report].

The aim of the paper was to describe dynamic changes in 'pump twin's' circulatory system within clinical observation, indication analysis for premature delivery due to cardiovascular findings and long-term postnatal follow up. In echocardiographic examination of 'pump twin' no structural heart defects but functional changes in cardiovascular system have been detected (cardiomegaly, right heart disproportion, tricuspid valve regurgitation). Within 10-week observation polyhydramnios did not increased significantly, no amnioreduction procedures had been performed. Due to single umbilical artery in 'pump twin' a cytogenetic examination had been performed revealing a normal karyotype. When the first signs of abnormal Doppler flows appeared such as increased PI of umbilical artery and DV and cardiomegaly with TR--caesarean section was performed at 33 weeks of gestation. Echocardiography performed in the first day of life findings: right atrium and ventricle enlargement, significant tricuspid valve regurgitation (V max 3 m/s), a prenatally undetected, small perimembrane-part ventricular septal defect. At the age of 6-months a non-significant VSD with tricuspid valve septal leaflet closure and ASD II has been confirmed. The infant is systematically followed-up by paediatricians, cardiologists and neurologists and her further neurodevelopment appears to be slightly retarded.