Misdiagnosis of an Acardiac Twin in the First Trimester, A Case Report
Journal Title: International Journal of Medical Reviews and Case Reports - Year 2017, Vol 1, Issue 2
Abstract
Background: Twin reversed arterial perfusion (TRAP) sequence is a rare monochorionic twin pregnancy complication. It should be suspected in the first trimester ultrasound, when one fetus has no cardiac activity in a monochorionic pregnancies. Doppler study is essential for early diagnosis of acardiac twin. This manuscrips shows the importance of reassessing cases considered as vanishing twins in early pregnancy, to avoid a late diagnosis of acardiac twin, without timely treatment. Case Summary: In this case, the assumption of death of one fetus in the first trimester, delayed the correct diagnosis of TRAP until 25 weeks, when the case was referred to our unit. We opted conservative management with weekly ultrasound surveillance, looking for features of heart failure in the pump twin. After suspecting fetal anemia, at 32 weeks a healthy baby weighing 2100g was delivered along with a acardiac anceps with 518g. This is a case of expectant management, for lack of another option, with a successful end. Conclusion: Despite twin reversed arterial perfusion (TRAP) sequence being a rare monochorionic twin pregnancies complication, it should be suspected in the first trimester ultrasound, when detected a monochorionic pregnancies and one embryo/fetus has no cardiac activity. Follow up in fetal death of one twin in a monochorionic pregnancies must be done with Doppler to look for acardiac twin. Because pump twin may develop a high-output cardiac failure and intrauterine fetal demise, for continuing pregnancies without poor prognostic criteria, it is important to maintain weekly ultrasound surveillance, with attention to the intervention criterias.
Authors and Affiliations
Catarina Vasconcelos, Vanessa Falé Rosado, Álvaro Cohen, Ana Teresa Martins, Rita Torres
Keywords
Related Articles
- EP ID EP427902
- DOI 10.5455/IJMRCR.acardiac-twin-first-trimester
- Views 153
- Downloads 0
Traditional Uvulectomy: Origin, Perception, burden and strategies of prevention
SUMMARY: Traditional uvulectomy is a procedure involving partial or total removal of uvula by traditional practitioners. Uvulectomy by traditional practitioners in Africa has been an age-long practice. The procedure sti...
SURGICAL MANAGEMENT OF TRAUMATIC MANUBRIO-STERNAL DISLOCATION WITH LOCKING COMPRESSION PLATE: A CASE REPORT AND REVIEW OF LITERATURE
Background: Manubriosternal joint dislocation as a result of trauma is rare with only few case reports published in literature. Materials that have been used for fixation of displaced manubriosternal joint are steel wire...
Role of Corticosteroids in the Management of Acute Traumatic Brain Injury: Literature Review and Critical Appraisal of Evidence
Background Traumatic brain injury is a prominent and leading cause of premature mortality and disability. Corticosteroids were widely used in the clinical management of traumatic brain injury but their benefit has been c...
An unusual case of shortness of breath: Aortic Arch Pseudo-Aneurysm
Here In we present a rare case of Shortness of Breath caused by massive trachea deviation due to a giant penetrating atherosclerotic ulcer of the aortic arch that simulates a lung lesion. It is of clinical and educationa...
METHODS FOR TREATMENT OF EXTRAHEPATIC BILE DUCT AFTER IATROGENIC LESIONS- OUR EXPERIENCE IN RECONSTRUCTIVE BILE SURGERY
Lesions of ductus choledohus are most common complications of gallbladder surgery. The latter especially became more frequent after the wide spread of laparoscopic technique in biliary surgery. According to various autho...