A rare case of acardiac acephalus twin pregnancy

Abstract

Acardiac twining also referred to as the twin reversed arterial perfusion sequence (TRAP) represents an extreme manifestation of the twin transfusion syndrome and has an incidence of approximately 1 in 35,000 deliveries . The acardiac twin is transfused by the normal co twin by means of reversal of circulation through large vein to vein and artery to artery anastomosis and has no direct communication with placenta. The acardiac twin presents with many bizarre anomalies thought to be due to low oxygen tension and dramatic alterations in the fetal physiology . Complications in the pump twin of an acardiac fetus include congenital heart failure, polyhydramnios, preterm labor and death in 50-70% of the cases. We present a case of acardiac – acephalus twin which was initially mistaken for a dead anomalous twin.