Acardiac Twin: A Case Report

Authors

  • Ranju Singh Department of Obstetrics and Gynecology, Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu.
  • Tripti Shrestha Department of Obstetrics and Gynecology, Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu.
  • Pushkar Bishwokarma Department of Anesthesiology and Critical Care, Nepal APF Hospital, Balambu, Kathmandu.
  • Shankar Shrivastav Department of Obstetrics and Gynecology, Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu.

DOI:

https://doi.org/10.31729/jnma.v64i302.9658

Keywords:

acardiac twin;, monochorionic twin;, TRAP Sequence.

Abstract

Acardiac twinning, or twin reversed arterial perfusion (TRAP) sequence, is a rare anomaly of monochorionic twins with an incidence of 1 in 35,000 births. We report a case of a 35-year-old G2P1L1 woman, previously diagnosed with singleton pregnancy during rural ANC visits, presented at 22+1 weeks of gestation whose detailed ultrasound revealed a twin pregnancy with a normal twin and a malformed twin with hydrops, caudal regression and rudimentary limbs, confirmed by MRI. After counseling on risks and options, the family opted for termination. Induction with mifepristone and misoprostol delivered a 560g normal male fetus and a 300g malformed acardiac mass with an identifiable limb sharing a single placenta, consistent with acardius myelacephalus. This case underscores the need
for early determination of chorionicity and careful ultrasonographic assessment in twin pregnancies to enable timely intervention and improve pump twin outcomes in resource-limited settings.

Downloads

Published

2026-09-30

How to Cite

Singh, R. ., Shrestha, T. ., Bishwokarma, P. ., & Shrivastav, S. (2026). Acardiac Twin: A Case Report. Journal of Nepal Medical Association, 64(302). https://doi.org/10.31729/jnma.v64i302.9658

Issue

Vol. 64 No. 302 (2026): JNMA: Published Monthly

Section

Case Reports

License

Copyright (c) 2026 Ranju Singh, Tripti Shrestha, Pushkar Bishwokarma, Shankar Shrivastav

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

JNMA allow to read, download, copy, distribute, print, search, or link to the full texts of its articles and allow readers to use them for any other lawful purpose. The author(s) are allowed to retain publishing rights without restrictions. The JNMA work is licensed under a Creative Commons Attribution 4.0 International License. More about Copyright Policy.