Uncommon case report of an acephalic-acardiac twin and review of the literature

Abstract

The TRAPS (Twin Reversed Arterial Perfusion Sequence) is an uncommon and specific complication of monozygotic genetic pregnancies. This anomaly is secondary to the presence of abnormal vascular connections between the twins, so it is a major form of the twin-to-twin transfusion syndrome. We present here a case of an acardiac-acephalic twin diagnosed during pregnancy at 27 weeks of amenorrhea. Thanks to advances in ultrasound, the antenatal diagnosis of the TRAP syndrome is made possible in the first trimester. This condition is associated with a high mortality rate in healthy twins caused by anemia and heart failure. Therapeutic resources involve in utero management such as the interruption of vascular anastomosis between the twins to perform a selective feticide.