Authors: Jombo S E, Ugadu CO, Dantani D,Ngwu  HO, Isabu P, Odike A , Alika SO

Abstract

Acardiac twins refer to a developmental anomaly unique to monochorionic pregnancies. It is a very rare complication that manifest as twin reversed arterial perfusion (TRAP) sequence as a result of vascular anastomoses at the placenta bed. We present a case of an undiagnosed acardiac anceps, delivered at 31 weeks gestation. A 25-year-old unbooked multigravida presented in labour and had an emergency Caesarean section with a finding of a monochorionic diamniotic twin gestation. Twin I was an acardiac anceps weighing 3000g with ambiguous genitalia, the umbilical cord was short (25cm long) with two arteries and one vein. Twin II was a live female baby, weighing 1500g, APGAR scores were 6 and 8 at the first and fifth minutes respectively. She had features of hydrops fetalis and congestive cardiac failure with a significant patent ductus arteriosus (PDA). Twin II (pump twin) however died on day 21 from refractory heart failure. Antenatal diagnosis and appropriate intervention is crucial to good outcome.

Keywords

Acardiac anceps, Twin Reversed Arterial Perfusion (TRAP), Monochorionic, Hydrops foetalis.

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Undiagnosed Acardiac Anceps Twins: A Case Report