diagnosis include biometric discordance between
the twins, the absence of identifiable cardiac pulsation
in one twin, poor definition of the head, trunk,
and upper extremities, deformed lower extremities,
marked and diffuse subcutaneous edema, and
abnormal cystic areas in the upper part of the body
of the affected twin. The presence of cardiac motion
does not exclude the diagnosis, as it may result from
a rudimentary heart or transmitted pulsation from
the cardiac function of the pump twin. Retrograde
perfusion from the pump twin to the acardiac twin
is the key point for diagnosis of TRAP (Fig. 4).