Parasitic Twin - Variants

Variants

• Conjoined-parasitic twins joined at the head are described as craniopagus or cephalopagus, and occipitalis if joined in the occipital region or parietalis if joined in the parietal region.
• Craniopagus parasiticus is a general term for a parasitic head attached to the head of a more fully developed fetus or infant.
• Fetus in fetu sometimes is interpreted as a special case of parasitic twin, but may be a distinct entity.
• The Twin reversed arterial perfusion, or TRAP sequence, results in an acardiac twin, a parasitic twin that fails to develop a head, arms and a heart. The parasitic twin, little more than a torso with or without legs, receives its blood supply from the host twin by means of an umbilical cord-like structure, much like a fetus in fetu, except the acardiac twin is outside the host twin's body. The blood received by the parastitic twin has already been used by normal fetus, and as such is already de-oxygenated, leaving little developmental nutrients for the acardiac twin. Because it is pumping blood for both itself and its acardiac twin, this causes extreme stress on the normal fetus's heart. Many TRAP pregnancies result in heart failure for the healthy twin. On 12 December 2008 a Brisbane mother watched this occur during ultrasound. She reported that "their heart just slowed and stopped. There was no jerking or movement from the babies. They just slowed and stopped". This twinning condition usually occurs very early in pregnancy. A rare variant of the acardiac fetus is the acardius acormus where the head is well-developed but the heart and the rest of the body are rudimentary. While it is thought that the classical TRAP/Acardius sequence is due to a retrograde flow from the umbilical arteries of the pump twin to the iliac arteries of the acardiac twin resulting in preferential caudal perfusion, acardius acormus is thought to be a result of an early embryopathy.