Advanced technology saves fetus in rare twin-pregnancy condition

Local medical specialists revealed the successful implementation of a sophisticated treatment to treat a very rare disease in which a lady is pregnant with one healthy fetus and one without a heart.

Twin reversed arterial perfusion sequence, also known as acardiac twinning, is a serious complication that occurs in only 1 percent of identical twin pregnancies.

During this condition, one twin is typically anatomically normal, while the other is an aberrant mass of tissue that includes legs and a lower body but no upper body, brain, or heart.

The normal fetus is known as the "pump twin" because its heart pumps blood to the aberrant bulk.

Thus, the "pump twin" bears the additional strain of having to deliver and receive blood to both the acardiac mass and its own expanding tissues. This can cause cardiac failure in the normal twin, who has a 50 to 70 percent probability of dying if not treated in time.

Doctors at the Shanghai International Peace Maternity and Child Health Hospital's Fengxian branch diagnosed the woman with the disease in the 12th week of her pregnancy after failing to find the head and heart in one fetus.

Detailed examinations confirmed the reversed arterial perfusion sequence and advised prompt therapy and intervention.

"The treatment is radiofrequency ablation, which employs a needle to stop the blood flow to the acardiac tumor while under real-time ultrasound monitoring. It can increase the typical fetus's survival rate by 80 to 90 percent," said Dr Wang Yanlin, a prenatal diagnostic expert.

"We typically perform the procedure after 16 weeks of pregnancy. However, this is a unique circumstance. If the normal fetus does not receive therapy in time, it can die at any time. Doctors face a greater challenge because the lady is only 13 weeks pregnant and the fetus is small."

Fortunately, the therapy went well. Following the cessation of blood supply, the acardiac mass will diminish and disappear. Doctors said that the follow-up exams indicated the normal fetus was growing well, and they expected the woman to deliver in a month's time.

Since the hospital's Fengxian branch opened in September 2022, it has performed almost 1,100 intrauterine diagnoses and treatments, as well as delivering nearly 200 pairs of twins, saving patients from having to travel to a major hospital in downtown, officials said.