July 2013 Vol. 1 No. 1

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Case Report

Acardiac twin – A unique complication of monozygotic twin

Dr. Jahanara Rahman

Associate Professor, Department of Obstetrics and Gynaecology, Dhaka National Medical College Hospital, Dhaka, Bangladesh.

E-mail: jahanararahman64@Gmail.com

Accepted June 30, 2013

Abstract

Acardiac foetus also referred as Twin Reversed Arterial Perfusion (TRAP) sequence is a unique complication of monozygotic twin where the parasitic twin fails to develop heart and upper part of the body. It is thought that the acardiac foetus develops from reversed circulation of artery-to-artery or vein to vein anastomosis without any vascular communication with the placenta. It has an incidence of approximately 1% of monozygotic twins or 1 in 35,000 deliveries. To report a rare event- acardiac foetus born with a monozygotic co-twin in 2008, Dhaka National Medical College and Hospital. An acardiac amorphous twin was delivered by caesarean section at 30 weeks of gestational age with an asphyxiated living co-twin weighing 1000gm. The normal co-twin was apparently devoid of any gross congenital anomaly but expired 48 hours after birth. As the case was undiagnosed prior to delivery, no antenatal attempt was taken to secure the healthy baby’s life by interrupting affected twin’s circulation. 

Keywords: Acardiac foetus, monozygotic twin, circulatory intervention