Journal List > Korean J Obstet Gynecol > v.53(5) > 1006419

Korean J Obstet Gynecol. 2010 May;53(5):449-454. Korean.
Published online May 31, 2010.  https://doi.org/10.5468/kjog.2010.53.5.449
Copyright © 2010 Korean Society of Obstetrics and Gynecology
A case of acardiac twin pregnancy with fetus survival after successful radiofrequency ablation of umbilical cord
Ji hyon Jang, M.D., Myoung Jin Moon, M.D., Hea Ree Park, M.D., Eun Hee Ahn, M.D., Sang Hee Jung, M.D., Yu mi Lee, M.D. and Eun A Kim, M.D.
Department of Obstetrics and Gynecology, CHA University, Bundang Cha Women's Hospital, Seoul, Korea.

Corresponding author (Email: mmj33@hanmail.net )
Received April 01, 2010; Accepted April 26, 2010.

Abstract

Acardiac twin is a rare anomaly that occurs 1% in monochorionic twins and 1 in 35,000 pregnancies overall. Acardiac twin, also known as twin-reversed arterial perfusion (TRAP) sequence, involves a "pump" or donor twin perfusing a recipient or "acardiac" twin through vascular (usually arterial-arterial and venous-venous) anastomoses. Perinatal mortality rate for the pump twin has been reported to be 50~75%, mainly as a result of polyhydramnios, preterm labor, and congestive heart failure. Therefore, occlusion of the circulation to the acardiac twin has been recommended to improve perinatal outcome of the pump twin. Radiofrequency ablation of the acardiac twin effectively protects the pump twin from high-output cardiac failure and death. We report our experience in the treatment of patients with TRAP sequence using radio frequency ablation to stop perfusion to the acardiac twin.

Keywords: Radiofrequency ablation; Monochorionic twin; Twin-reversed arterial perfusion (TRAP); Acardiac twin

Figures


 Fig. 1
(A) cord insertion site: doppler ultrasound image of cord insertion site at the anterior abdominal wall of the acardiac fetus. (B) the tissue effects of radiofrequency ablation (RFA): transabdominal intraoperative ultrasound image reveals the RFA device, deployed within the abdomen of the acardiac fetus, and the echogenic material, which represents the tissue effects of RFA.
Click for larger image


Fig. 2
The acardiac twin and monochorionic diamniotic placenta. It shows the umbilical cord of the acardiac twin contains two vessels, one vein and one artery.
Click for larger image

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