Acardiac Amorphous Twins – A case report

About author
Dr. C. Bharath*, Dr. Srikoustubha
Department of of Pathology, Medical college(VIMS), BELLARY-583 104, India       
E-mail: [email protected]

Abstract
Acardiac twining also referred as the Twin Reversal Arterial Perfusion (TRAP) sequence, is a rare congenital malformation found in monozygotic twin pregnancy.This case report is based on physical examination and autopsy findings.Grossly, a formless blob covered with skin, where a small portion of cord was attached to ventral surface. The cephalic pole, had tuft of hair and at lower end a rudimentary limb bud was seen. No recognizable facial or other part differentiation noticed. On autopsy, organs were absent and  tuft of vessels noticed in upper part. The umbilical cord, histologically showed one artery and one vein, without any glial tissue in cephalic end. The acardius syndrome is a rare complication of monozygotic twin pregnancy. The twin reversal arterial perfusion theory is most accepted etiology of this disorder. A vascular communication exists between the twins and usually normal twin may develop cardiac failure as a result of perfusion of abnormal twin. In this case there was absence of development of cephalic pole, it being most distal to retrograde perfusion.
Key words: Congenital, Twin pregnancy, Acardaic, Amorphous, TRAP, Autopsy.