Masroor Imrana, Jeelani Sarah, Aziz Aliya, Idrees Romana
Department of Radiology, Aga Khan university Hospital Karachi , Karachi, PAK.
Post Graduate Medical Education, Aga Khan University Hospital, Karachi, PAK.
Cureus. 2018 Jul 2;10(7):e2910. doi: 10.7759/cureus.2910.
Acardiac twin formation is a rare anomaly. It is one of the most extreme complications of monozygotic twin pregnancies. Such occurrences are brought about when a normal twin donates blood to an abnormal twin through its umbilical arteries via vascular anastomoses at the level of the placenta, which is termed as twin reversed arterial perfusion sequence (TRAPS). Twin reversed arterial perfusion sequence is considered a rare variant of twin-to-twin transfusion syndrome. Due to the considerable blood transfer from the healthy twin to the parasitic one, cardiac failure can ensue in the healthy twin. The mortality of the acardiac twin is 100%. We present an obstetric case of a South Asian female, whose serial ultrasound scans consistently displayed a heterogeneous mass, initially labeled a teratoma. This was postoperatively diagnosed as an acardiac twin due to TRAPS. Thus, we would like to highlight the importance of umbilical artery Doppler in the prompt diagnosis of TRAPS so timely management may be undertaken to prevent morbidity and/or mortality of the normal twin.
无心双胎形成是一种罕见的异常情况。它是单卵双胎妊娠最极端的并发症之一。当一个正常双胎通过胎盘水平的血管吻合经其脐动脉向一个异常双胎供血时，就会出现这种情况，这被称为双胎反向动脉灌注序列（TRAPS）。双胎反向动脉灌注序列被认为是双胎输血综合征的一种罕见变异型。由于健康双胎向寄生双胎有大量血液转移，健康双胎可能会出现心力衰竭。无心双胎的死亡率为100%。我们报告一例南亚女性的产科病例，其系列超声扫描始终显示一个不均质肿块，最初被标记为畸胎瘤。术后因TRAPS被诊断为无心双胎。因此，我们想强调脐动脉多普勒在TRAPS快速诊断中的重要性，以便能及时进行处理，防止正常双胎出现发病和/或死亡。
