Transvaginal ultrasound diagnosis of twin reversed arterial perfusion syndrome at 9 weeks' gestation.

ABSTRACT

Diagnosis of twin reversed arterial perfusion syndrome was made using transvaginal sonography at 9 weeks' gestation. The morphological evaluation of the abnormal twin revealed a dysmorphic cephalic pole and absence of the upper extremities. There was diffuse subcutaneous edema and no detectable cardiac activity. The other twin had a normal appearance and a size compatible with the gestational age. The fetuses were divided by a thin amniotic membrane with normal amniotic fluid in both sacs. Diagnosis was confirmed by demonstrating fetal growth and lower limb activity in the abnormal twin 10 days later.