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 International Journal of Medical Reviews and Case Reports

International Journal of Medical Reviews and Case Reports
ISSN (online) : 2534-9821
ISSUES : 4/year
PUBLISHER : Bulgarian Association of Young Surgeons

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Case Report Open Access


Misdiagnosis of an Acardiac Twin in the First Trimester, A Case Report.

Catarina Vasconcelos, Vanessa Falé Rosado, Álvaro Cohen, Ana Teresa Martins, Rita Torres.

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.

Key words: TRAP sequence, acardiac fetus


 
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How to Cite this Article
Pubmed Style

Vasconcelos C, Rosado VF, Cohen Á, Martins AT, Torres R. Misdiagnosis of an Acardiac Twin in the First Trimester, A Case Report.. Int J Med Rev Case Rep. 2017; 1(2): 41-45. doi:10.5455/IJMRCR.acardiac-twin-first-trimester



Web Style

Vasconcelos C, Rosado VF, Cohen Á, Martins AT, Torres R. Misdiagnosis of an Acardiac Twin in the First Trimester, A Case Report.. www.scopemed.org/?mno=272026 [Access: September 22, 2017]. doi:10.5455/IJMRCR.acardiac-twin-first-trimester



AMA (American Medical Association) Style

Vasconcelos C, Rosado VF, Cohen Á, Martins AT, Torres R. Misdiagnosis of an Acardiac Twin in the First Trimester, A Case Report.. Int J Med Rev Case Rep. 2017; 1(2): 41-45. doi:10.5455/IJMRCR.acardiac-twin-first-trimester



Vancouver/ICMJE Style

Vasconcelos C, Rosado VF, Cohen Á, Martins AT, Torres R. Misdiagnosis of an Acardiac Twin in the First Trimester, A Case Report.. Int J Med Rev Case Rep. (2017), [cited September 22, 2017]; 1(2): 41-45. doi:10.5455/IJMRCR.acardiac-twin-first-trimester



Harvard Style

Vasconcelos, C., Rosado, V. F., Cohen, Á., Martins, A. T. & Torres, R. (2017) Misdiagnosis of an Acardiac Twin in the First Trimester, A Case Report.. Int J Med Rev Case Rep, 1 (2), 41-45. doi:10.5455/IJMRCR.acardiac-twin-first-trimester



Turabian Style

Vasconcelos, Catarina, Vanessa Falé Rosado, Álvaro Cohen, Ana Teresa Martins, and Rita Torres. 2017. Misdiagnosis of an Acardiac Twin in the First Trimester, A Case Report.. International Journal of Medical Reviews and Case Reports, 1 (2), 41-45. doi:10.5455/IJMRCR.acardiac-twin-first-trimester



Chicago Style

Vasconcelos, Catarina, Vanessa Falé Rosado, Álvaro Cohen, Ana Teresa Martins, and Rita Torres. "Misdiagnosis of an Acardiac Twin in the First Trimester, A Case Report.." International Journal of Medical Reviews and Case Reports 1 (2017), 41-45. doi:10.5455/IJMRCR.acardiac-twin-first-trimester



MLA (The Modern Language Association) Style

Vasconcelos, Catarina, Vanessa Falé Rosado, Álvaro Cohen, Ana Teresa Martins, and Rita Torres. "Misdiagnosis of an Acardiac Twin in the First Trimester, A Case Report.." International Journal of Medical Reviews and Case Reports 1.2 (2017), 41-45. Print. doi:10.5455/IJMRCR.acardiac-twin-first-trimester



APA (American Psychological Association) Style

Vasconcelos, C., Rosado, V. F., Cohen, Á., Martins, A. T. & Torres, R. (2017) Misdiagnosis of an Acardiac Twin in the First Trimester, A Case Report.. International Journal of Medical Reviews and Case Reports, 1 (2), 41-45. doi:10.5455/IJMRCR.acardiac-twin-first-trimester



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