Key result
An undiagnosed acardiac twin was delivered at 39 weeks alongside a healthy live born baby, demonstrating a case where the normal twin survived without intervention despite the TRAP sequence.
Case Report (n=1)
No
Early diagnosis of acardiac twin is essential to monitor the normal twin for features of heart failure.
Healthy term delivery possible with undiagnosed TRAP; leaves open optimal timing of intervention in monochorionic twins.
Acardiac twinning or Twin Reverse Arterial Perfusion (TRAP)-sequence is a rare complication of monochorionic twin pregnancy. Whether to start elective or therapeutic treatment in TRAP-sequence is still controversial. In the present case, acardiac twin was not diagnosed till her delivery at 39 weeks. A healthy baby weighing 2.45 kg was delivered along with another amorphous mass (acardiac twin) of about 150 g which was attached to the placenta with a short and separate cord. As outcome of normal twin vary according to the growth of acardiac twin, frequent follow-up of the normal twin is required to look for the features of heart failure. Hence, the diagnosis of acardiac twin is essential in early pregnancy.
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Sunita Dubey (2017) conducted a case report in Twin Reversed Arterial Perfusion (TRAP) sequence (n=1). Expectant management (undiagnosed) was evaluated. An undiagnosed acardiac twin was delivered at 39 weeks alongside a healthy live born baby, demonstrating a case where the normal twin survived without intervention despite the TRAP sequence.