Radiofrequency Ablation and Intrauterine Transfusion in a Delayed Diagnosed Acardiac Twin Pregnancy

Author:

Rahimi-Sharbaf Fatemeh1,Shirazi Mahboobeh1,Hessami Kamran2ORCID,Saleh Maasoumeh13ORCID,Golshahi Fatemeh3,Saeedi Sara1,Shirdel Abdolmaleki Abolfazl4,Mousavi Vahed Seyede Houra5,Nouri Behnaz6,Sahebdel Behrokh1

Affiliation:

1. Department of Obstetrics and Gynecology, Maternal Fetal and Neonatal Research Center, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran

2. Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA

3. Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

4. Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

5. Department of Obstetrics and Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran

6. Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran

Abstract

Twin reversed arterial perfusion (TRAP) sequence or acardiac twin is a rare and severe complication of monochorionic multiple pregnancies. Acardiac twin accounts for 10% of all TRAP sequences, which is the most morphologically developed acardius. We present an undiagnosed TRAP sequence case up to 24 weeks of gestation who underwent successful amnioreduction, radiofrequency ablation (RFA), and intrauterine transfusion (IUT). During follow-up, hydrops of surviving co-twin disappeared, and fetal heart function improved. Finally, a healthy girl weighing 2400 g was born at 36 weeks of gestation. To our knowledge, this is the first reported acardiac twin pregnancy, which requires IUT, in addition to RFA, due to late diagnosis. Therefore, this case report presents successful management options for TRAP sequence cases diagnosed late in pregnancy.

Publisher

Hindawi Limited

Subject

Obstetrics and Gynecology

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