ABSTRACT
Twin reversed arterial perfusion (TRAP) sequence is a serious condition of monochorionic twin pregnancy, occurring in approximately one in 35,000 cases. First trimester treatment of TRAP sequence is controversial with higher incidence of procedure related complications. Present case demonstrates a TRAP sequence that was managed by intrauterine treatment with one-ml 100% pure alcohol injection into the abdominal part of the umbilical artery and obliteration of the acardiac twin at 14 weeks of gestation. Antenatal follow-up was uneventful and elective cesarean section was performed at 39 weeks' gestation. Postnatal outcome of the pump twin was excellent at 30 months after birth. Early second trimester elective ablation by alcohol injection can be an inexpensive, alternative, and reasonable minimal invasive treatment option to prevent fetal loss of pump twin before mid and late second trimester in perinatology centers where intrafetal cord occlusive methods are not available.
Subject(s)
Ethanol/therapeutic use , Fetofetal Transfusion/therapy , Heart Defects, Congenital , Pregnancy Reduction, Multifetal/methods , Solvents/therapeutic use , Adult , Cesarean Section , Female , Gestational Age , Humans , Pregnancy , Pregnancy Trimester, First , Pregnancy Trimester, Second , Pregnancy, Twin , Severity of Illness Index , Umbilical ArteriesABSTRACT
Spontaneous dissection of the extracranial internal carotid artery (ICA) is increasingly being recognized as a common vascular disease. We report on a 52-year-old-male presented with bilateral extracranial internal artery dissection and twelfth nerve palsy and review the previous literature.
