PMC6452551_01
Ultrasonic color Doppler image of the acardiac fetus at 16 weeks of gestation. Blood flow is observed in the navel of the acardiac fetus, which is stuck to the anterior uterine wall. Complete cessation of blood flow in the acardiac fetus was successful with a single puncture.
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fig1
The acardiac fetus was stuck to the anterior uterine wall and the other sac did not interfere with needle insertion (Figure 1).
Photograph of the placental vascular surface. The black arrow indicates the anastomoses between the acardiac fetus and the direct pump fetus. The white arrow indicates the anastomoses between the direct pump fetus and the indirect pump fetus. (1) is the anastomoses between the umbilical artery of the direct pump fetus and the umbilical artery of the indirect pump fetus. (2) is the anastomoses between the umbilical vein of the direct pump fetus and the two umbilical veins of the indirect pump fetus. The gray arrow indicates the direction of blood flow in the vascular anastomoses.
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fig2
Placental examination showed four vascular anastomoses between triplets B and C (Figure 2) and vascular anastomoses (i.e., umbilical artery and umbilical vein) between triplets A and B.