Case Report: Twin Reversed Arterial Perfusion Sequence in a Triplet Natural Pregnancy: Case Report from Korle Bu Teaching Hospital, Accra, Ghana and a Review of the Literature

Abstract

Background: Twin reversed arterial perfusion sequence is probably the most severe malformation found in humans. It is also called acardia , acardiac twinning or acardius acephalus and is a very rare condition that occurs in monozygotic twins and rarely in triplet pregnancy. It has not been described in the West African Medical literature. A case was recorded in a twin delivery at the labour ward four years ago in the same hospital but the underlying diagnosis was not made.
Objective:To describe a rare case of twin reversed arterial perfusion sequence occurring in a triplet pregnancy and review the current literature.
Methods: A case was evaluated at the delivery ward, Department of Obstetrics and the Neonatal unit of the Korle Bu Teaching Hospital upon information from the obstetric team that a monster had been born from a triplet set. Full documentation was done.
Results: The case documented was a twin reversed arterial perfusion sequence in a triplet pregnancy.
Conclusion: This rare condition has been well characterized and Obstetricians and Paediatricians should now be able to make an accurate diagnosis.

Keywords: Twin reversed arterial perfusion (TRAP) sequence, Acardiac acephalus.