Twin reversed arterial perfusion (TRAP sequence), or acardiaus, is a rare and serious complication of monozygotic multiple gestation. The acardiac fetus suffers from lethal anomalies. The normal co-twin also runs a high risk of perinatal morbidity and mortality due to heart failure and prematurity. Four cases of acardius are presented. The role of sonography in the condition's diagnosis and management is discussed.
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