To summarize the prenatal ultrasound image features and pregnancy outcomes of twin reverse arterial perfusion syndrome.

The ultrasound images and pregnancy outcomes were analyzed in 11 cases of twin reverse arterial perfusion syndrome diagnosed prenatally in Suzhou Municipal Hospital for the period from 2012 January to 2014 December.

Three cases of twin reverse arterial perfusion syndrome in 11 cases were monochorionic single amniotic sac twins and eight cases were monochorionic double amniotic sac twins. Acardias ultrasound foundings: (1) Malformation type: five cases were absence of the fetal body and heart, four cases were absence of fetal head and heart (visible trunk and lower limbs, no upper limbs), two cases were part absence of fetal head (visible trunk and limbs). (2) Accompanied malformation: eleven cases were absence of cardiac pump with body skin edema (three cases of lymphatic hygroma and one case of ascites and pleural effusion), in which the blood in all umbilical artery flowed back into the abdominal cavity, ten cases of single umbilical artery. Pump twins ultrasound foundings: (1) The fetal heart beat pumping was detected in all pump twins. (2) Accompanied malformation: one case of pumping fetus had multiple malformations, including former holoprosencephaly, central cleft lip, the left foot inversion and ventricular septal defect. Another case of pumping fetus heart had left axis deviation with the volume of right atrium and right ventricle increasing, single umbilical artery and left renal sinus separation. Follow-up pregnancy outcomes: eleven cases of twin reverse arterial perfusion syndrome fetus were abortion to terminate the pregnancy and postpartum autopsy pathology diagnosed TRAPS.

Twin reverse arterial perfusion syndrome has typical ultrasound image features. Ultrasonography is of great value in prenatal diagnosis and clinical intervention of twin reverse arterial perfusion syndrome.