Pathognomonic sign of twin reversed arterial perfusion using color Doppler sonography

• Published in: Journal of ultrasound in medicine Vol. 16; no. 7; pp. 501 - 503
• Main Authors: Papa, T, Dao, A, Bruner, J P
• Format: Journal Article
• Language: English
• Published: Laurel, MD American Institute of Ultrasound in Medicine 01-07-1997
• Subjects: Adult; Biological and medical sciences; Blood vessels; Chorion; Color image processing; Diagnosis; Diseases in Twins; Diseases of mother, fetus and pregnancy; Doppler effect; Female; Fetus - abnormalities; Gynecology. Andrology. Obstetrics; Heart Defects, Congenital - diagnostic imaging; Humans; Medical imaging; Medical problems; Medical sciences; Placental Circulation; Pregnancy; Pregnancy Trimester, Second; Pregnancy. Fetus. Placenta; Regional Blood Flow; Twins, Monozygotic; Ultrasonography, Doppler, Color; Ultrasonography, Prenatal; Umbilical Cord - physiopathology; Sonography; Doppler ultrasound study; Human; Pregnancy disorders; Cardiovascular disease; Acardiac; Congenital disease; Artery; Color image; Venous disease; Arterial disease; Vascular disease; Case study; Symptomatology; Arteriovenous aneurysm; Malformation; Perfusion; Female; Technique; Vein; Twin pregnancy
• ISSN: 0278-4297; 1550-9613
• DOI: 10.7863/jum.1997.16.7.501

A cardiac twinning occurs in approximately 1% of monochorionic twin pregnancies. In this malformation, a network of artery-to-artery and vein-to-vein anastomoses develops within the conjoined placentas early in embryonic development. The anomalous nature of these anastomoses leads to a TRAP sequence, with normal circulation in the 'pump' twin and retrograde perfusion of the acardiac twin. Malformations in the acardiac twin usually include an absent or misshapen heart and an amorphous upper body and head. These features are visible on prenatal sonograms but may mimic fetal hydrops of one twin. We report a pathognomonic sign for TRAP detected by color Doppler sonography at 27 weeks' gestation in a patient with an acardiac twin pregnancy.