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Acardiac twins: a case series.

Jamal Yaqoob1, Khubaib Shahid, Muhammad Imran Aslam

  • 1Department of Radiology, Fatima Memorial Hospital, Shadman, Lahore.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|December 12, 2007
PubMed
Summary
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Acardiac twinning, or Twin Reversed Arterial Perfusion (TRAP) sequence, is a rare complication where one twin lacks a heart. Early diagnosis via ultrasound is crucial for managing this high-risk condition.

Area of Science:

  • Perinatology
  • Maternal-Fetal Medicine
  • Reproductive Biology

Background:

  • Acardiac twinning is a severe complication of monochorionic placentation.
  • The acardiac twin is non-viable, and the surviving twin faces high mortality (50-70%) due to circulatory demands.
  • This condition necessitates close monitoring and timely intervention.

Purpose of the Study:

  • To describe three cases of acardiac twinning, now termed Twin Reversed Arterial Perfusion (TRAP) sequence.
  • To highlight the importance of early antenatal diagnosis through sonographic monitoring.
  • To emphasize the critical role of delivery timing in improving outcomes for the surviving twin.

Main Methods:

  • Case series presentation of three pregnancies with acardiac twinning.

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  • Emphasis on close sonographic monitoring for antenatal diagnosis.
  • Discussion of management strategies focusing on delivery timing.

    • Main Results:

    • Three cases of TRAP sequence were identified and managed.
    • The study underscores the challenges in managing this rare condition.
    • Sonographic monitoring is vital for early detection and planning.

    Conclusions:

    • Twin Reversed Arterial Perfusion (TRAP) sequence is a rare but serious complication of monochorionic pregnancy.
    • Early antenatal diagnosis via ultrasound is essential for optimizing fetal survival.
    • Careful management, including appropriate timing of delivery, is critical for the surviving twin.