P09.06: Twin gestation of a complete mole and a normal fetus and placenta. Optimizing the medical management with three‐dimensional ultrasound. Case report

Abstract

Twin reversed arterial perfusion (TRAP sequence) occurs only in the setting of a monochorionic pregnancy and complicates 1 percent of monochorionic twin gestations, with an incidence of 1 in 35,000 births. In the TRAP sequence, the acardiac/acephalic twin receives all of its blood supply from the normal, 'pump twin'. A case of TRAP sequence was diagnosed at 8 weeks of gestation using transvaginal three-dimensional color Doppler ultrasound. Ultrasound imaging showed a monochorionic-monoamniotic twin pregnancy with normal morphology and growth of the first twin. Three-dimensional ultrasound examination showed growth restriction of the second twin, abnormal cephalic pole with acrania, no presence of cardiac activity, and presence of retrograde perfusion in the umbilical artery of the abnormal twin. With the three-dimensional ultrasound images that we presented, we showed that early diagnosis of acardiac twins is possible. Early confirmation of TRAP sequence allows early treatment and better outcome of pregnancy. P09.04 An early diagnosis of trisomy 18 by 2-3-4D at 10th week