Publication:

Acardia twin-twin reversal arterial perfusion sequence

Acardia twin is a rare, unique complication of monochorionic twin pregnancy. A 2.6% incidence among monochorionic twins has been cited. In such complications a twin with abnormal or non-functional heart is perfused by its co-twin via placental arterial anastomosis. The acardia twin has a poorly developed heart and upper torso. We present a case in which the fetal demise of one fetus of twin pregnancy has been diagnosed in the first trimester, but the patient wishes to continue the pregnancy. This resulted in the unexpected occurrence of an acardia twin after delivery along with one normal twin, placenta was single. A review is presented on therapeutic opportunities and necessity of thorough sonographic evaluation in monochorionic multifetal pregnancies.