The twin reversed arterial perfusion is a rare condition with a non-viable acardiac twin and a lot of risks to the pump twin (prematurity, cardiac failure, hydrops and intrauterine demise). It was first described in 1942 [9]. This condition cannot be prevented and is unique to monozygotic monochorionic twin gestations, and if untreated is associated with a high (50% - 75%) perinatal mortality of the pump twin, especially when acardiac/twin ratio is greater than 70% of the size of the pump twin by estimated weight [2] [4] . It is more common in nulliparous women [4]. The pump twin is structurally normal, may develop polyhydramnios and cardiac failure. The acardiac twin is usually grossly abnormal with oligohydramnios and two-vessel umbilical
