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Acardiac twins: Failure to diagnose can lead to devastation

In our previous two blog posts, we discussed how fetal distress and meconium aspiration syndrome can affect your newborn baby. While those topics might seem scary to some of our Kentucky readers, there are other issues that pregnant women might face. One of those issues is the possibility of having an undiagnosed pregnancy complication. In this post, we will discuss acardiac twins and how devastating it can be when a doctor doesn't diagnose the condition early in the pregnancy.

Acardiac twins is a condition in which the blood from one twin is delivered to the other twin in a flow that is backwards. This condition is serious because it means one twin isn't getting the oxygen it needs. This condition, which is also known as twin reversed-arterial perfusion sequence, is life threatening.

When this condition is diagnosed early in the pregnancy, it is sometimes possible for the mother to undergo surgery to try to save the twins. Without any intervention, the acardiac twin, or the twin receiving the oxygen-depleted blood from the pump twin, will not survive outside the womb. Even with surgical intervention, the success rate of saving both twins isn't high, but the chance of saving the pump twin is up to 85 percent.

Surgery must be done between 16 and 26 weeks gestation, which means that early diagnosis is necessary. Doctors who monitor twin pregnancies should check for this condition, which affects monochorionic-monoamniotic twins. Generally, one twin is larger than the other and other markers such as polyhydramniosis, or high amniotic fluid, and abnormal Doppler measurements are present.

A pregnant woman who finds out early that she has a TRAP sequence pregnancy can choose how to proceed. When a doctor doesn't diagnose the condition, the pregnant woman doesn't have that option, which can put her twins and her life in jeopardy. In that case, she might choose to seek compensation from the doctor on a failure to diagnose basis.

Source: Children's Hospital Los Angeles, "Acardiac Twins" Oct. 15, 2014

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