We describe a rare case of acardius in a triplet pregnancy terminated by Caesarean Section at 32 weeks gestation. Morphological and chromosomal abnormalities of the fetus as well as structural abnormalities of the placenta are presented. Cytogenetic analysis and examination of the single disc triplet placenta provide evidence for the two major theories of pathogenesis of acardius, the twin reversed arterial perfusion (TRAP) sequence and the genetic theory, which we believe are not necessarily mutually exclusive.
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Ultrasonic identification of pump twin by dual-gate Doppler in a monochorionic-triamniotic triplet twin reversed arterial perfusion sequence before preventative radiofrequency ablation: a case report.
J Med Ultrason (2001)
January 2018
Department of Fetal-Maternal Medicine, Nagara Medical Center, 1300-7, Nagara, Gifu, 502-87558, Japan.
We performed a dual-gate Doppler examination for a twin reversed arterial perfusion (TRAP) sequence in a monochorionic-triamniotic triplet pregnancy at 16 weeks of gestation and were able to identify the pump twin by arterial pulse rate synchronicity. We performed radiofrequency ablation to coagulate blood flow in the acardius at 16 weeks of gestation without any postoperative complication. At 29 weeks of gestation, we performed a cesarean section due to preterm rupture of the membranes and the patient delivered 1167/1237-g female neonates and a macerated acardius.
View Article and Find Full Text PDFForty cases of twin reversed arterial perfusion sequence treated with radio frequency ablation using the multistep coagulation method: a single-center experience.
Prenat Diagn
May 2016
Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
Objective: To report the pregnancy outcomes of patients with twin reversed arterial perfusion (TRAP) sequence treated by radiofrequency ablation (RFA).
Methods: This was a retrospective study of TRAP sequences treated in a single center between March 2002 and February 2015. Forty patients underwent RFA with expandable tines through a multistep coagulation method between 15 and 26 gestational weeks.
Fetal echopsy (ultrasonographic autopsy) of an acardius myelancephalus and its correlation with antenatal ultrasonographic findings.
Indian J Radiol Imaging
January 2016
Department of Ultrasonography, Balku's Scan, PVS Hospital, Calicut, Kerala, India.
Aberrant transplacental arteriovenous shunts between the placental and cord vessels of monozygotic monoamniotic twins or triplets result in the formation of an acardius. The prenatal diagnosis of this condition has been reported occasionally in the literature. A subtype categorized as acardius myelancephalus was diagnosed at 32 weeks of gestation by ultrasonography (USG).
View Article and Find Full Text PDFTwin reversed arterial perfusion sequence in a triplet natural pregnancy:case report from Korle Bu Teaching Hospital, Accra, Ghana and a review of the literature.
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Department of Child Health, University of Ghana Medical School.
Background: Twin reversed arterial perfusion sequence is probably the most severe malformation found in humans.It is also called acardia ,acardiac twinning or acardius acephalus and is a very rare condition that occurs in monozygotic twins and rarely in triplet pregnancy. It has not been described in the West African Medical literature.
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Arch Gynecol Obstet
July 2012
Department of Gynecology and Obstetrics, University of Schleswig-Holstein Medical Center, Luebeck, Germany.
Objectives: We analyse the prenatal detection and pregnancy outcome of twin reversed arterial perfusion syndrome (TRAP-sequence) in monochorionic twin pregnancies.
Methods: We included all cases in which the prenatal diagnosis of a TRAP-sequence had been established and reviewed the prenatal, obstetrical, and pathological records of the acardiac twin as well as the neonatal/pediatric records of the donor twin. Minimal follow-up for the donor twin after birth was 6 months.
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