Intrafetal laser therapy in acardiac twin pregnancy: a case report

Objective: In this study, we aimed to present the case of acardiac twin pregnancy (twin reversed arterial perfusion sequence, TRAP) successfully treated with intrafetal laser therapy. Case: Monochorionic diamniotic twin pregnancy, a fetus without heart (acardiac fetus) and a second fetus with normal appearance (pump fetus) were observed in the anterior placenta during USG examination of the pregnant women who admitted to our clinic at her 14 weeks of gestation. Retrograde blood flow was monitored via Doppler USG and she was established with the diagnosis of TRAP. At her 15 weeks of gestation, abdominal aortic and iliac vein lines were coagulated electively by intrafetal laser procedure, and it was found that acardiac fetus was avascular, so the procedure was ended. In gestational follow-up visits, it was seen that acardiac fetus did not grow and regressed. Pump fetus development and Doppler findings had a normal progress. On the 37 weeks and 3 days of gestation, 2800 g live newborn with 8–9 Apgar score was delivered. The development of ten-month-old newborn was normal and no complication was observed. Conclusion: Our case supports the fact that elective intrafetal laser procedure improves gestational outcomes between 12 and 16 weeks of gestation in acardiac twin pregnancies.