tailieunhanh - báo cáo khoa học: "Twin reversed arterial perfusion (TRAP) sequence in association with VACTERL association: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Twin reversed arterial perfusion (TRAP) sequence in association with VACTERL association: a case report | Athwal et al. Journal of Medical Case Reports 2010 4 411 http content 4 1 411 JOURNALOF medical case reports CASE REPORT Open Access Twin reversed arterial perfusion TRAP sequence in association with VACTERL association a case report Sharan Athwal Katherine Millard Kokila Lakhoo Abstract Introduction Twin reversed arterial perfusion TRAP sequence is a rare complication of multiple pregnancy caused by defects in early embryogenesis. The pump twin supplies the acardiac recipient twin with blood and although the pump twin is usually structurally normal congenital anomalies have sometimes been reported. We report a unique case of twin reversed arterial perfusion sequence with a prenatal diagnosis of VACTERL association in the surviving pump twin. Case presentation A 24-year-old Caucasian woman presented at 11 weeks gestation with a monochorionic monoamniotic twin pregnancy. A reversed arterial flow was noted on a Doppler imaging study coming from the larger apparently normal twin to the smaller grossly abnormal twin and a diagnosis of twin reversed arterial perfusion sequence was made. Cardiac activity was undetectable in the recipient twin by 16 weeks gestation. Further detailed assessment at 18 weeks gestation revealed multiple congenital anomalies of the surviving pump twin in keeping with a diagnosis of VACTERL association. A live infant girl was delivered at 39 weeks by elective cesarean section. She underwent extensive surgery with subsequent normal development at the age of two years. Conclusion The co-existence of two rare and complex conditions in this unique case raises interesting questions about the role of early defects in embryogenesis and their subsequent effects on fetal development. This case also highlights the importance of prenatal diagnosis of major congenital anomalies to the plan treatment reduce morbidity and aid the survival of affected children. Introduction Twin reversed arterial perfusion TRAP sequence is a rare .