OJOG  Vol.4 No.7 , May 2014
Late Presentation of Acardiac Twin: A Case Report and Review of Literature
ABSTRACT

Acardiac twinning or TRAP-sequence is a rare complication of monochorionic twin pregnancy. We present a case in which fetal demise of one fetus of a twin pregnancy had been wrongly diagnosed in the first trimester as a vanishing twin. This resulted in the unexpected occurrence of an acardiac twin in the third trimester, culminating in an acardiac twin with a birth weight higher than that of the normal twin. A review is presented on therapeutic opportunities including ligation of the umbilical cord under ultrasound or fetoscopy. This case report highlights the need for correct and early ultrasonographic diagnosis of chorionicity and detailed ultrasonographic follow-up of twin pregnancies.


Cite this paper
Hartog, M. , Toolenaar, T. and Jacquemyn, Y. (2014) Late Presentation of Acardiac Twin: A Case Report and Review of Literature. Open Journal of Obstetrics and Gynecology, 4, 379-382. doi: 10.4236/ojog.2014.47056.
References
[1]   Vandenbussche, F.P.H.A., Deprest J.A., Klumper, F.J.C.M., Vandenbroucke, W.V.A., Sollie, K.M. and Kanhai, H.H.H. (2003) Minimaal invasieve intra-uteriene chirurgische behandeling bij vier monochoriale tweelingzwangerschappen gecompliceerd door een acardiacus. Nederlands Tijdschrift voor Geneeskunde, 147, 931-936.

[2]   Lee, H., Bebbington, M. and Crombleholme, T.M. (2013) The North American Fetal Therapy Network Registry Data on Outcomes of Radiofrequency Ablation for Twin-Reversed Arterial Perfusion Sequence. Fetal Diagnosis and Therapy, 33, 224-229. http://dx.doi.org/10.1159/000343223

[3]   Tan, T.Y.T. and Sepulveda, W. (2003) Acardiac Twin: A Systematic Review of Minimally Invasive Treatment Modalities. Ultrasound in Obstetrics & Gynecology, 22, 409-419.
http://dx.doi.org/10.1002/uog.224

[4]   Lewi, L., Valencia, C., Gonzalez, E., Deprest, J. and Nicolaides, K.H. (2010) The Outcome of Twin Reversed Arterial Perfusion Sequence Diagnosed in the First Trimester. American Journal of Obstetrics & Gynecology, 203, e1-e4.

[5]   Prasad, R.H.S., Prasad, T.R. and Kumar, K.D. (2012) TRAP-Sequence—An Interesting Entity in Twins. Journal of Clinical Imaging Science, 2, 56. http://dx.doi.org/10.4103/2156-7514.100997

[6]   Hartge, D.R. and Weichert, J. (2012) Prenatal Diagnosis and Outcome of Multiple Pregnancies with Reversed Arterial Perfusion (TRAP-Sequence). Archives of Gynecology and Obstetrics, 286, 81-88. http://dx.doi.org/10.1007/s00404-012-2283-9

[7]   Sullivan, A.E., Varner, M.W., Ball, R.H., Jackson, M. and Silver, R.M. (2003) The Management of Acardiac Twins: A Conservative Approach. American Journal of Obstetrics & Gynecology, 189, 1310-1313. http://dx.doi.org/10.1067/S0002-9378(03)00597-0

[8]   Okai, T., Ichizuka, K., Hasegawa, J., et al. (2013) First Successful Case of Non-Invasive in Utero Treatment of TRAP-Sequence by High Intensity Focused Ultrasound. American Journal of Obstetrics & Gynecology, 42, 112-114. http://dx.doi.org/10.1002/uog.12466

 
 
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