title: Twin reversed arterial perfusion sequence in a triplet natural pregnancy:case report from Korle Bu Teaching Hospital, Accra, Ghana and a review of the literature.
abstract: BACKGROUND
  Twin reversed arterial perfusion sequence is probably the most severe malformation found in humans.It is also called acardia ,acardiac twinning or acardius acephalus and is a very rare condition that occurs in monozygotic twins and rarely in triplet pregnancy. It has not been described in the West African Medical literature. A case was recorded in a twin delivery at the labour ward four years ago in the same hospital but the underlying diagnosis was not made.
  
  
  OBJECTIVE
  To describe a rare case of twin reversed arterial perfusion sequence occurring in a triplet pregnancy and review the current literature.
  
  
  METHODS
  A case was evaluated at the delivery ward,Department of Obstetrics and the Neonatal unit of the Korle Bu Teaching Hospital upon information from the obstetric team that a monster had been born from a triplet set. Full documentation was done.
  
  
  RESULTS
  The case documented was a twin reversed arterial perfusion sequence in a triplet pregnancy.
  
  
  CONCLUSIONS
  This rare condition has been well characterized and Obstetricians and Paediatricians should now be able to make an accurate diagnosis.
authors.affiliation: Department of Child Health, University of Ghana Medical School.
authors.forename: E V
authors.initials: EV
authors.lastname: Badoe
authors.forename: A
authors.initials: A
authors.lastname: Darko
authors.forename: B H
authors.initials: BH
authors.lastname: Atuguba
mesh_terms: D000015:Abnormalities, Multiple / Q000473:pathology*; D000328:Adult; D000757:Anencephaly / Q000473:pathology*; D005260:Female; D005330:Fetofetal Transfusion / Q000473:pathology*; D005869:Ghana; D006330:Heart Defects, Congenital / Q000473:pathology*; D006784:Hospitals, Teaching; D006801:Humans; D011247:Pregnancy; D014310:Triplets