A 26-year-old primigravida with a spontaneously conceived monochorionic diamniotic twin pregnancy was diagnosed with an acardiac twin at 12 weeks (Fig. 1). She underwent interstitial laser under local anesthesia at 13 weeks (Fig. 2). The pump twin remained healthy on subsequent scans (Fig. 3). She went in spontaneous labor at 39 weeks and delivered a healthy baby boy weighing 3100 g with Apgar 9/10.
Fig. 1.
2D (a) and 3D (b) ultrasound showing the acardiac fetus in MCDA twin pregnancy with twin reversed arterial perfusion (TRAP) sequence
Fig. 2.
Color Doppler showing (a) cord insertion of the acardiac fetus and (b) cessation of blood flow in the acardiac fetus following interstitial laser
Fig. 3.
Post-interstitial laser-ablated acardiac fetus at subsequent anomaly scan
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Dr Chanchal Singh
has done MBBS from Lady Hardinge Medical College and MD (Obs&Gyn) from Maulana Azad Medical College, New Delhi. She obtained her MRCOG in 2010 and did a clinical fellowship in Maternal-Fetal Medicine from National University Hospital, Singapore. She obtained FICOG in 2019. She is a Fetal Medicine Foundation (UK) certified sonographer currently working as senior consultant in Fetal Medicine at Birthright, Rainbow Hospitals, New Delhi. She has publications in peer reviewed journals and has contributed several chapters in books. She hopes to excel in her chosen field and wishes to bring it in as part of the regular curriculum in postgraduate training. She is actively involved in FOGSI certified ultrasound training programmes and conducts regular CTG and Doppler workshops.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
Informed Consent
Informed consent was taken from the patient prior to performing the procedure. Consent has been obtained from her for reporting this case and care has been taken not to divulge any identifying information.
Footnotes
Dr Chanchal Singh is a MD (ObGyn), MRCOG, FICOG, Senior Consultant, Fetal Medicine at Birthright, Rainbow Hospitals, Malviya Nagar, New Delhi, India. Dr Meenakshi Bannerjee is a MBBS, MS (ObGyn), Senior Consultant, Obstetrics and Gynaecology at Birthright, Rainbow Hospitals, Malviya Nagar, New Delhi, India. Dr Manju Gupta is a MBBS, MS (ObGyn), Consultant, Obstetrics and Gynaecology at Jaypee Hospital, Noida, Uttar Pradesh, India.
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