Results: 13 pregnancies were followed at our centre: 2 were managed conservatively, in 2 cases we made a cord-occlusion and transection (COT), 2 had a fetal demise before IFL, and 7 were treated with IFL. In our series, we observed a rate of survival of 100% in the conservative management group, of 100% in the COT group and of 57% in the IFL group. Ten studies for a total of 156 cases were included in the meta-analysis. The overall neonatal survival after IFL was 79% (95% CI 0.72-0.86, I 2 22%). A random-effects model comparing neonatal survival for IFL performed before 16 +0 weeks versus at or more than 16 +0 weeks showed no statistically significant difference between the two groups (OR = 0.93; 95% IC 0.37-2.33). Conclusions: IFL is a safe and minimally invasive technique that allows treatment of TRAP sequence, with an overall survival rate of 79%. Gestational age at treatment (before or after 16 weeks) does not seem to affect neonatal survival rate. Given the risk of spontaneous pump twin demise, this would favour early treatment but needs to be confirmed by ongoing randomised controlled studies. VP40.