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Twin Reversed Arterial Perfusion Sequence Presenting as Acardius Anceps in a Monochorionic Diamniotic Twin Pregnancy: A Case Report |
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Maneesha Sharma, Jyoti Rani, Jyoti Rohila, Manpreet Kaur 1. Professor and Head, Department of Anatomy, AIMS, Mohali, Chandigarh, Punjab, India. 2. Demonstrator, Department of Anatomy, MMIMSR, Mullana, Ambala, Haryana, India. 3. Assistant Professor, Department of Anatomy, AIMS, Mohali, Chandigarh, Punjab, India. 4. Senior Resident, Department of Pathology, AIMS, Mohali, Mohali, Punjab, India. |
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Correspondence Address : Jyoti Rohila, Assistant Professor, Department of Anatomy, Dr. B. R. Ambedkar State Institute of Medical Sciences (AIMS), Mohali (S.A.S. Nagar)-160055, Punjab, India. E-mail: jyotirohilla5671@gmail.com |
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| ABSTRACT |  | ||||||
: Twin pregnancies are associated with significantly higher risks of morbidity and mortality compared to singleton gestations. Among twin pregnancies, Monochorionic (MC) twins present a unique set of complications due to their shared placenta and vascular connections. One rare and severe complication is the Twin Reversed Arterial Perfusion (TRAP) sequence. Hereby, the authors present a case report of an acardius anceps foetus delivered by 25-year-old female with features observed on gross examination, including absence of craniofacial structures, an incomplete calvarium, a hypoplastic thorax lacking the heart and lungs and syndactylous limbs, while the gastrointestinal tract was preserved. The MC diamniotic placenta showed two umbilical cords on a shared chorionic plate. Histology demonstrated mature tertiary villi with syncytial knots, intact trophoblastic layers, decidual tissue and focal villous calcification. The present case underscores the severity of the TRAP sequence and the critical importance of early prenatal diagnosis and intervention. Delayed recognition, as seen in present case, can result in fatal consequences for the pump twin. | |||||||
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| Keywords : Decidual tissue, Perinatal mortality, Placental anastomosis, Pump twin, Syncytial knots | |||||||
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DOI and Others :
DOI: 10.7860/IJARS/2026/85940.3127
Date of Submission: Jan 28, 2026 Date of Peer Review: Mar 30, 2026 Date of Acceptance: Jun 09, 2026 Date of Publishing: Sep 01, 2026 AUTHOR DECLARATION: • Financial or Other Competing Interests: None • Was informed consent obtained from the subjects involved in the study? Yes • For any images presented appropriate consent has been obtained from the subjects. Yes PLAGIARISM CHECKING METHODS: • Plagiarism X-checker: Jan 31, 2026 • Manual Googling: Jun 02, 2026 • iThenticate Software: Jun 08, 2026 (1%) ETYMOLOGY: Author Origin EMENDATIONS: 7 |
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Case report
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