Rare Case of Twin Reversed Arterial Perfusion Acardius Acephalus Subtype Seen in a Community-Based Hospital.

Background TRAP sequence occurs in monochorionic pregnancies consisting of one normal fetus and a non-viable fetus. The pump twin has an increased risk of developing high-output cardiac failure. Case 32-year-old G4P2012 with TRAP syndrome in current pregnancy presented to triage at 26 weeks with contractions and spotting. She had undergone RFA for selective reduction at another facility. Placental abruption was suspected and patient underwent a cesarean section. Twin A was delivered alive although she subsequently succumbed due to complications of prematurity. Conclusion This case highlights the importance of early detection and consistent prenatal care in the management of TRAP sequence. Further research of interventions associated with improved outcomes should be encouraged.

Influenza and Tdap Vaccines: Practices and Perception among Hispanic Women attending Tertiary Center in Puerto Rico.

OBJECTIVE: Explore influenza and Tdap immunization knowledge, attitudes, and practices among Hispanics patients attending prenatal care in a tertiary hospital in Puerto Rico as well as barriers encountered by patients regarding vaccination practices during pregnancy. METHODS: Descriptive study conducted at the University District Hospital prenatal care clinics in the Medical Sciences Campus of Puerto Rico from September 2016 to June 2017. RESULTS: A total of 189 pregnant women were recruited. Regarding Influenza vaccine: 75.6% were offered or oriented about Influenza vaccination, 51.8% had received the vaccine at least once (only 12.2% during current pregnancy) and, 57.1% reported receiving information about influenza infection risks in pregnancy, mainly from health care professionals and media. For Tdap only 20.6% of women were offered or oriented about the vaccine and 7.4% received the vaccine during pregnancy. 55.6% of patients had not been oriented about potential dangers of the pertussis infection; for the few oriented, health professionals were their predominant source. In terms of barriers, lack of information about vaccination and its benefits during pregnancy were the most frequent. CONCLUSION: Our study identifies the existing gap of information regarding Influenza and Tdap vaccine. Physicians play a pivotal role in preventive care and new strategies are needed to optimize education to our patients.