scholarly journals Acardiac Twin

2014 ◽  
Vol 2 (2) ◽  
pp. 77-80 ◽  
Author(s):  
MS Maherunnessa ◽  
Rahima Begum ◽  
Samsad Jahan ◽  
Shamsunnahar Bela ◽  
Syeda Riffat Binta Habib ◽  
...  
Keyword(s):  
Twin Pregnancy ◽  
Umbilical Artery ◽  
Rare Complication ◽  
Multiple Pregnancy ◽  
The Body ◽  
Reverse Direction ◽  
Arterial Perfusion ◽  
Blood Flows ◽  
Acardiac Twin ◽  
Pump Twin

Acardiac anomaly is a rare complication of multiple pregnancies. It is a hemodyamically disadvantaged nonviable twin which occurs in association with a twin reversed arterial perfusion sequence (TRAP). In TRAP, blood flows from an umbilical artery of the pump twin in reverse direction into umbilical artery of the perfused (or acardiac) twin via an arterial to arterial (AA) anastomosis. Its blood is poorly oxygenated and results in variable degrees of deficient development of the head, heart, and upper limb structures. The lower half of the body is usually better developed, which may be explained by the mechanism of perfusion. The pump twin is at risk of heart failure and problems related to preterm birth with a reported mortality of 50-75%. We present a case of multiple pregnancy with acardiac twin in a 26 year old lady with gestational diabetes mellitus. During ante natal check up several ultrasonographic (USG) screening showed twin pregnancy with one healthy fetus and the other fetus with inconspicuous anatomy and structure. Repeat USG at 36th week of gestation diagnosed twin pregnancy with acardiac twin. Strikingly the pump twin did not develop the usual complications and was delivered by cesarean section at 37th week of gestation. DOI: http://dx.doi.org/10.3329/dmcj.v2i2.20529 Delta Med Col J. Jul 2014; 2(2): 77-80

scholarly journals A Case of Trap Sequence with Immense Acardiac Twin

Folia Medica ◽  
2014 ◽  
Vol 56 (2) ◽  
pp. 129-132
Author(s):  
Georgi I. Amaliev ◽  
Maria L. Malinova ◽  
Blagovest K. Pehlivanov ◽  
Hristina A. Ivancheva
Keyword(s):  
Twin Pregnancy ◽  
Rare Complication ◽  
Arterial Perfusion ◽  
Acardiac Twin ◽  
Trap Sequence ◽  
Complicated Pregnancy ◽  
Twin Reversed Arterial Perfusion ◽  
Normal Twin ◽  
Pump Twin

Abstract Twin-reversed arterial perfusion sequence is a rare complication of monochorionic twin pregnancy in which an anomalous acardiac fetus is hemodynamically dependent on its structurally normal “pump” twin. Early diagnosis is essential for improving perinatal prognosis for the normal twin. In this case report we present a case of TRAP sequence with immense acardiac twin with favorable outcome, emphasizing the importance of ultrasound imaging, follow-up and timing of delivery in this complicated pregnancy.

scholarly journals Acardiac Acephalus Twin Pregnancy

2019 ◽  
Vol 10 (1) ◽  
pp. 89-91
Author(s):  
Shamim Rima ◽  
Gule Tajkia ◽  
Sharmin Siddika ◽  
Md Tarik Aziz ◽  
Rumana Amin ◽  
...  
Keyword(s):  
Blood Supply ◽  
Umbilical Artery ◽  
Monozygotic Twins ◽  
The Body ◽  
Upper Body ◽  
Arterial Perfusion ◽  
Medical College ◽  
Acardiac Twin ◽  
Twin Reversed Arterial Perfusion ◽  
Pump Twin

Occurrence of acardiac twin is due to twin reversed arterial perfusion sequence (TRAP) occurring early in embryogenesis. There is vascular communication between the twins in monozygotic twins. The vascular communication in acardiac twin is different, in that, the acardiac twin receives blood supply from other twin pump through umbilical artery. The blood in the umbilical artery is mostly deoxygenated. Hence it leads to secondary organ atrophy. Upper body does not develop at all, hence missing heart and head. All the blood supply to the acardiac twin is derived from the pump twin. The acardiac twin develops only lower part of the body or just a mass of tissue. Hence, the mortality for acardiac twin is 100%. Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 89-91

scholarly journals Acardiac – Acephalus Twin – A Rare Case Report and Review of Literature

2015 ◽  
Vol 01 (01) ◽  
pp. 008-011
Author(s):  
Mukta Mital ◽  
Tanuj Garg ◽  
Prashant Gupta ◽  
Vinit Nanda
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Twin Pregnancy ◽  
Rare Complication ◽  
The Body ◽  
Review Of Literature ◽  
Acardiac Twin ◽  
Severe Reduction ◽  
Rare Case Report ◽  
Pump Twin

AbstractAcardiac twin pregnancy is a rare complication of monochorionic twinning caused by aterioarterial and venovenous placental anastomosis, leading to circulatory predominance of one twin (1). The donor “pump’ twin provides circulation for itself as well as and for the recipient acardiac twin. The acardiac twin is usually grossly abnormal with severe reduction anamolies of the upper part of the body. We present a case of acephalus acardiac anomaly diagnosed by ultrasound, with subsequent post delivery followup.

scholarly journals Twin Reversed Arterial Perfusion (TRAP) Syndrome or acardiac twin: a case report in Madagascar

2018 ◽  
Vol 6 (5) ◽  
pp. 1790
Author(s):  
Lyn Z. A. Rabetsimamanga ◽  
Hary F. Rabarikoto ◽  
Maheriandrianina F. V. Rajaonarivony ◽  
Setriny M. Ravoavy ◽  
Hery R. Andrianampanalinarivo
Keyword(s):  
Twin Pregnancy ◽  
Rare Complication ◽  
Cardiac Activity ◽  
Upper Body ◽  
Premature Delivery ◽  
Arterial Perfusion ◽  
Acardiac Twin ◽  
Gestational Week ◽  
Short Time ◽  
Twin Reversed Arterial Perfusion

TRAP syndrome is a rare complication of monochorionic twin pregnancy. It is characterized by the association of an acardiac twin with a healthy twin. The acardiac twin is a parasite who put the healthy twin at high risk of cardiac failure. We report a case in a 25-year-old Malagasy woman, primigravida, who had a consultation at gestational week 31 for significant dyspnea and a threat of premature delivery. Ultrasound scans discovered an acute polyhydramnios, fetus with anasarca and low cardiac activity, and a para-fetal mass. She gives birth to a male newborn and an acardiac twin without head an upper body. The first twin died short time after birth.

MCMA acardiac twin: a trap?

2017 ◽  
Vol 6 (7) ◽  
pp. 3182
Author(s):  
Vinayachandran S. ◽  
Vedhapriya Sudhakar
Keyword(s):  
Rare Complication ◽  
Expectant Management ◽  
Monozygotic Twin ◽  
Arterial Perfusion ◽  
Acardiac Twin ◽  
Retrograde Perfusion ◽  
Arterial Anastomosis ◽  
Pump Twin

Acardiac twining or Twin Reverse Arterial Perfusion (TRAP) is a rare complication of monozygotic twin occurring due to retrograde perfusion of acardiac twin by structurally normal pump twin through abnormal arterio-arterial anastomosis in the placenta. Here we report a case of unexpected occurrence of acardiac twin diagnosed as monozygotic monoamniotic twin (MCMA) gestation with single foetal demise due to multiple anomalies, delivered vaginally suggesting a role for expectant management.

scholarly journals Is it correct to trust each ultrasonography report blindly? a case report on misdiagnosis, diagnosis and management of acardiac twin pregnancy

2020 ◽  
Vol 9 (6) ◽  
pp. 2628
Author(s):  
Pooja Chandak ◽  
Shobha Toshniwal
Keyword(s):  
Case Report ◽  
Twin Pregnancy ◽  
Rare Complication ◽  
Fetal Medicine ◽  
Monochorionic Twin ◽  
Arterial Perfusion ◽  
Acardiac Twin ◽  
Risk Pregnancy ◽  
Twin Pregnancies ◽  
Multifetal Pregnancy

Multifetal gestation is often a high-risk pregnancy and especially the monochorionic twin pregnancy significantly contributes to fetal morbidity and mortality. Acardiac twinning, earlier known as chorioangiopagus parasiticus, is the most extreme manifestation of this condition. An acardiac twin is a rare complication of multifetal pregnancy, in the literature reported at an incidence of 1% of monochorionic twin pregnancies, i.e. 1 of 35,000 pregnancies. Often results from abnormal placental vascular anastomoses. This leads to twin reversal arterial perfusion with complex pathophysiology. Here authors present a case of acardiac twin pregnancy presented at 26 weeks with the ultrasonography report suggested?? Placental teratoma of size 11×11×13 cm with polyhydramnios as there was no reason to suspect something else as the picture described in the USG report with the polyhydramnios was fitting with the diagnosis of placental teratoma but as the scan was done at taluka place and the images provided were not clear authors decided to confirm the diagnosis from fetal medicine specialist as MTP was not the option for the patient as she was 28 weeks who confirmed that as a case of acardiac twin pregnancy and the case was managed accordingly.

scholarly journals Acardia anceps: the monster twin; twin reversed arterial perfusion (TRAP) syndrome

2018 ◽  
Vol 7 (11) ◽  
pp. 4775
Author(s):  
Shazia Khan ◽  
Tina Singh ◽  
Gunadhar Maiti
Keyword(s):  
Imaging Techniques ◽  
Rare Complication ◽  
Cardiac Activity ◽  
Well Being ◽  
Reverse Direction ◽  
Arterial Perfusion ◽  
Trap Sequence ◽  
Twin Reversed Arterial Perfusion ◽  
Live Baby ◽  
Pump Twin

Twin reversed arterial perfusion (TRAP) sequence is an extremely rare complication of monochorionic multi-foetal pregnancy, occurring once in 35,000 births. It is characterized by a malformed foetus without a heart being perfused by a structurally normal (pump) twin via an artery-to-artery anastomosis in a reverse direction. We report one such case where ultrasound imaging revealed monochorionic twin pregnancy with a viable, normal-appearing first twin and a structurally aberrant second twin with absent cardiac activity. The patient was monitored with two weekly ultrasonography and Doppler ultrasound examination to ascertain the well-being of the pump twin. She delivered successfully at term a normal live baby and an acardius anceps foetus. The perinatal mortality of the pump twin ranges from 35 to 55%; making it essential to diagnose the presence of a pump twin at an early gestational age through improved imaging techniques to plan effective intervention at appropriate time.

scholarly journals Twin Reversed Arterial Perfusion Sequence: A Rare Entity

2015 ◽  
Vol 5 ◽  
pp. 9
Author(s):  
Sachin Khanduri ◽  
Saakshi Chhabra ◽  
Anshul Raja ◽  
Saurav Bhagat
Keyword(s):  
Gestational Age ◽  
Imaging Techniques ◽  
Rare Complication ◽  
Well Being ◽  
Reverse Direction ◽  
Intrauterine Pregnancy ◽  
Arterial Perfusion ◽  
Trap Sequence ◽  
Twin Reversed Arterial Perfusion ◽  
Pump Twin

Twin reversed arterial perfusion (TRAP) sequence is an extremely rare complication of monochorionic multi-fetal pregnancy, occurring once in 35,000 births. This condition is characterized by a malformed fetus without a cardiac pump being perfused by a structurally normal (pump) twin via an artery-to-artery anastomosis in a reverse direction. We report a case of a primigravida, who came for routine antenatal checkup to our hospital at 31 weeks gestational age. Ultrasound imaging and magnetic resonance imaging revealed twin monochorionic intrauterine pregnancy with a viable, normal-appearing first twin and amorphous structured second twin connected by umbilical vessels. The patient was monitored with weekly ultrasonography, echocardiography, and Doppler ultrasound examination to ascertain the well-being of the pump twin. She delivered successfully at term a normal live baby and an acardius acephalus fetus. Plain X-ray of the acardius acephalus fetus confirmed the absence of cephalic structures. The perinatal mortality of the pump twin ranges from 35 to 55%; hence, it is essential to diagnose the presence of a pump twin at an early gestational age through improved imaging techniques, so that intervention can be planned early in the pregnancy for a better outcome of the pump twin.

scholarly journals Advances in Ultrasonic Assessment of Acardiac Twin

2011 ◽  
Vol 5 (3) ◽  
pp. 213-218
Author(s):  
Florin Stamatian ◽  
Daniel Muresan ◽  
Gabriela Caracostea ◽  
Tunde Kovacs
Keyword(s):  
Reverse Flow ◽  
Subcutaneous Tissue ◽  
Rare Complication ◽  
Final Diagnosis ◽  
Arterial Perfusion ◽  
Acardiac Twin ◽  
Trap Sequence ◽  
Fetal Movements ◽  
Ultrasonic Assessment ◽  
Pump Twin

ABSTRACT The development of an acardiac anomaly, one of the most severe human malformations, is a rare complication unique to monochorionic multiple pregnancies. In this condition, the primary malformation is the lack of a well-defined cardiac structure in one twin (the acardiac twin), which is kept alive by its structurally normal co-twin (the pump twin). The final diagnosis for a twin pregnancy with an acardiac twin may be established after the 9th week, when the cephalic extremity and limbs can be precisely determined. Direct signs that lead to the diagnosis of an acardiac twin include the absence of cardiac and fetal movements, difficult visualization of the trunk and cephalic poles, thickening of subcutaneous tissue and the presence of umbilical artery reverse flow towards the acardiac fetus mass. The pump fetus may demonstrate hydramnios, cardiomegaly and heart failure. Once an acardiac anomaly is diagnosed, both the acardiac and pump twins should be assessed to classify the pregnancy according to prognostic factors based on the size and growth of the acardiac twin and the cardiovascular condition of the pump twin. Assessing the extent of heart damage in the pump fetus is a key step in pregnancy management. There are two available options, either conservative or interventional, for the management of these pregnancies. Serial ultrasound surveillance is important for detecting any worsening of the condition, which may suggest the need for interventions to optimize the pump-twin's chance for survival. We performed a retrospective analysis of three cases of monochorionic twin pregnancies diagnosed with a twin reversed arterial perfusion (TRAP) sequence during the first and second trimesters. We compared our data with those offered by a review of the literature.

scholarly journals Conservative management of a case of a cardiac anceps twin reversed arterial perfusion sequence misdiagnosed as vanishing twin: a case report

2020 ◽  
Vol 10 (1) ◽  
pp. 385
Author(s):  
Jharna Behura ◽  
Ayushi Sinha ◽  
Aafreen Naaz ◽  
Soni Bharti
Keyword(s):  
Conservative Management ◽  
Multiple Pregnancy ◽  
Cardiac Activity ◽  
Laser Coagulation ◽  
Variable Degree ◽  
Arterial Perfusion ◽  
Acardiac Twin ◽  
Trap Sequence ◽  
Twin Reversed Arterial Perfusion ◽  
Pump Twin

Twin reversed arterial perfusion (TRAP) sequence is a specific, rare and severe complication of monochorionic multiple pregnancy, which is characterized by one normal fetus (pump twin) and another with no cardiac activity and variable degree of deficient development of the head and upper limbs. The management of these pregnancies are a real challenge due to the parasitic hemodynamic dependence of the acardiac twin on the pump twin. The aim of management is to maximize the chances of survival of the pump twin with some intervention. The preferred management suggested is elective ultrasound-guided laser coagulation or radiofrequency ablation of the umbilical cord vessels at 11-13 weeks when the survival is 70-75%. Delay in intervention until 16-18 weeks is associated with spontaneous cessation of blood flow in the acardiac twin in 60% of cases and in about 50% of these there is death or brain damage in the pump twin. However, pregnancies diagnosed late need to follow a tailored approach with expectant management. The authors report a case of TRAP twin sequence which on ultrasound was diagnosed as a case of vanishing twin at 20 weeks. Subsequently on follow up ultrasound, it was diagnosed as a trap sequence with the pump twin developing polyhydramnios at 30 weeks. She was counselled regarding the prognosis of the pump twin and she opted for conservative management. Weekly ultrasound and color doppler were done. The amniotic fluid index (AFI) decreased gradually at 33 and 35 weeks, there were no signs of congestive cardiac failure of the pump twin on Doppler studies and she had a spontaneous delivery of a healthy male child and an acardiac anceps fetus at 36weeks and 5 days. The perinatal mortality of a pump twin managed conservatively ranges from 35 to 55%. It is essential to diagnose the presence of trap sequence at an early gestational age through improved imaging techniques to plan a timely and effective intervention to salvage most of the pump twins.

Sign in / Sign up

Export Citation Format

Share Document