GÊMEO ACÁRDICO: UMA REVISÃO SISTEMÁTICA SOBRE INTERVENÇÃO POR MEIO DE ABLAÇÃO DOS VASOS PLACENTÁRIOS

Fetal acardia is a rare complication that affects monochorionic/diaminiotic twin pregnancies. It is characterized by the presence of a fetus that does not have a heart (acardiac fetus) or has a rudimentary heart (hemicardiac fetus). Its epidemiology, including risk factors, is poorly understood, and the diagnosis is made by ultrasound (US) and confirmed by reverse flow of the umbilical artery by Doppler US. The ideal management is controversial, ranging from conservative conduct, with observation and serial examinations, to treatments that interrupt fetal circulation. The therapeutic modality recognized as the gold standard is ablation of the placental vessels. Thus, the objective of this article is to present a systematic review of the literature on the benefits of the therapeutic modality through ablation of the placental vessels for cases of fetal acardia. This is a systematic review conducted in the National Institutes of Health, Scientific Electronic Library and Virtual Health Library databases. The search priority was for studies with humans, randomized clinical trials, prospective and retrospective cohort studies, case-control and cross-sectional studies, available in full and published in the last 25 years. The association of the descriptors used in the databases searched allowed us to find a total of 56 articles. After applying the inclusion and exclusion criteria, 5 articles were selected and analyzed, which allowed us to conclude that placental ablation is an efficient and safe therapeutic alternative for fetal acardia.