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Fetal magnetic resonance imaging, ultrasound, and echocardiography findings in twin reversed arterial perfusion sequence.
Pediatr Radiol
May 2024
Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.
Article Synopsis
- TRAP sequence involves a unique situation in multiple pregnancies where one twin (the pump twin) supports the nonviable co-twin (the acardius), necessitating careful monitoring via fetal MRI.
- A study analyzed 88 TRAP pregnancies over 17 years, uncovering that around 12% of live pump twins exhibited abnormalities, particularly related to the brain and heart.
- MRI revealed three acardius types, with differences in acardius-to-pump twin volume ratios correlated to the pump twin's heart health, highlighting the importance of imaging for monitoring these high-risk pregnancies.
Acardius acephalus with spontaneous umbilical cord occlusion: Reporting a rare case.
Radiol Case Rep
May 2022
Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India.
Twin reversed arterial perfusion syndrome is a rare obstetric condition that occurs in monochorionic twin pregnancies, resulting in coexistence of a normal "pump" twin and an acardiac twin. The acardiac twin is dependent upon the normal twin to provide circulation by means of vascular anastomosis, thereby putting the pump fetus at risk of high output cardiac failure. Overall only 50% of pump twins survive.
View Article and Find Full Text PDFHypothesized pathogenesis of acardius acephalus, acormus, amorphus, anceps, acardiac edema, single umbilical artery, and pump twin risk prediction.
Birth Defects Res
March 2022
Department of Pathology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.
Background: Acardiac twinning complicates monochorionic twin pregnancies in ≈2.6%, in which arterioarterial (AA) and venovenous placental anastomoses cause a reverse circulation between prepump and preacardiac embryos and cessation of cardiac function in the preacardiac. Literature suggested four acardiac body morphologies in which select (groups of) organs fail to develop, deteriorate, or become abnormal: acephalus (≈64%, [almost] no head, part of body, legs), amorphus (≈22%, amorphous tissue lump), anceps (≈10%, cranial bones, well-developed), and acormus (≈4%, head only).
View Article and Find Full Text PDFAcardius anceps with neck cyst and cleft palate: Three dimensional skeletal computed tomography reconstruction with discussion of the literature.
Birth Defects Res
January 2020
Department of Clinical Chemistry Hematology and Immunology, Diakonessenhuis, Utrecht, The Netherlands.
Acardiac twinning is a rare anomaly of monochorionic twin pregnancies. Acardiac fetuses lack a functional heart but are passively perfused by arterial blood from their pump co-twin causing the acardiac body to be hypoxemic. In this report, we present an acardius anceps, therapeutically laser separated from its pump twin at 16 weeks.
View Article and Find Full Text PDFACR Appropriateness Criteria Multiple Gestations.
J Am Coll Radiol
November 2017
Valley Hospital, Ridgewood, New Jersey and NYU School of Medicine, New York, New York; American College of Obstetrics and Gynecology.
Women with twin or higher-order pregnancies will typically have more ultrasound examinations than women with a singleton pregnancy. Most women will have at minimum a first trimester scan, a nuchal translucency evaluation scan, fetal anatomy scan at 18 to 22 weeks, and one or more scans in the third trimester to evaluate growth. Multiple gestations are at higher risk for preterm delivery, congenital anomalies, fetal growth restriction, placenta previa, vasa previa, and velamentous cord insertion.
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