Diagnosis and Management of Twin Reversed Arterial Perfusion Sequence at the Korle Bu Teaching Hospital, Ghana

Abstract

Twin Reversed Arterial Perfusion (TRAP) sequence is a rare complication of twin gestation unique to monochorionic twins, reported to occur in about 1% of all monochorionic pregnancies. In this condition, an acardiac twin, with an absent or non-functioning heart, is perfused by its co-twin (referred to as the “pump” twin) via placental anastomoses. It is associated with a high mortality for the pump twin without intervention. We report two cases of TRAP sequence diagnosed prenatally by ultrasound at the Korle Bu Teaching Hospital. We describe how this rare anomaly can be diagnosed and managed successfully even in a low resource setting to yield good perinatal outcomes.