“…36,45,46 Other rare cases of absent umbilical cord have been reported, such as the recent publication of prenatal sonographic confirmation of the recipient twin in a case of twin reversed arterial perfusion (TRAP) sequence, which was completely embedded in the placenta with no evidence of an umbilical cord at delivery (Figure 2). 47 In contrast to other fetal organs, the placenta or the uterine cervix, the umbilical cord is seldom depicted or tracked sonographically throughout its entire length. This reflects a number of reasons.…”
“… 36 , 45 , 46 Other rare cases of absent umbilical cord have been reported, such as the recent publication of prenatal sonographic confirmation of the recipient twin in a case of twin reversed arterial perfusion (TRAP) sequence, which was completely embedded in the placenta with no evidence of an umbilical cord at delivery ( Figure 2 ). 47 Figure 2 Absent umbilical cord in a (twin reverse arterial perfusion TRAP) twin embedded within the placenta. Note the absence of an umbilical cord to this fetus.…”
The umbilical cord constitutes a continuation of the fetal cardiovascular system anatomically bridging between the placenta and the fetus. This structure, critical in human development, enables mobility of the developing fetus within the gestational sac in contrast to the placenta, which is anchored to the uterine wall. The umbilical cord is protected by unique, robust anatomical features, which include: length of the umbilical cord, Wharton's jelly, two umbilical arteries, coiling, and suspension in amniotic fluid. These features all contribute to protect and buffer this essential structure from potential detrimental twisting, shearing, torsion, and compression forces throughout gestation, and specifically during labor and delivery. The arterial components of the umbilical cord are further protected by the presence of Hyrtl's anastomosis between the two respective umbilical arteries. Abnormalities of the umbilical cord are uncommon yet include excessively long or short cords, hyper or hypocoiling, cysts, single umbilical artery, supernumerary vessels, rarely an absent umbilical cord, stricture, furcate and velamentous insertions (including vasa previa), umbilical vein and arterial thrombosis, umbilical artery aneurysm, hematomas, and tumors (including hemangioma angiomyxoma and teratoma). This commentary will address current perspectives of prenatal sonography of the umbilical cord, including structural anomalies and the potential impact of future imaging technologies.
“…36,45,46 Other rare cases of absent umbilical cord have been reported, such as the recent publication of prenatal sonographic confirmation of the recipient twin in a case of twin reversed arterial perfusion (TRAP) sequence, which was completely embedded in the placenta with no evidence of an umbilical cord at delivery (Figure 2). 47 In contrast to other fetal organs, the placenta or the uterine cervix, the umbilical cord is seldom depicted or tracked sonographically throughout its entire length. This reflects a number of reasons.…”
“… 36 , 45 , 46 Other rare cases of absent umbilical cord have been reported, such as the recent publication of prenatal sonographic confirmation of the recipient twin in a case of twin reversed arterial perfusion (TRAP) sequence, which was completely embedded in the placenta with no evidence of an umbilical cord at delivery ( Figure 2 ). 47 Figure 2 Absent umbilical cord in a (twin reverse arterial perfusion TRAP) twin embedded within the placenta. Note the absence of an umbilical cord to this fetus.…”
The umbilical cord constitutes a continuation of the fetal cardiovascular system anatomically bridging between the placenta and the fetus. This structure, critical in human development, enables mobility of the developing fetus within the gestational sac in contrast to the placenta, which is anchored to the uterine wall. The umbilical cord is protected by unique, robust anatomical features, which include: length of the umbilical cord, Wharton's jelly, two umbilical arteries, coiling, and suspension in amniotic fluid. These features all contribute to protect and buffer this essential structure from potential detrimental twisting, shearing, torsion, and compression forces throughout gestation, and specifically during labor and delivery. The arterial components of the umbilical cord are further protected by the presence of Hyrtl's anastomosis between the two respective umbilical arteries. Abnormalities of the umbilical cord are uncommon yet include excessively long or short cords, hyper or hypocoiling, cysts, single umbilical artery, supernumerary vessels, rarely an absent umbilical cord, stricture, furcate and velamentous insertions (including vasa previa), umbilical vein and arterial thrombosis, umbilical artery aneurysm, hematomas, and tumors (including hemangioma angiomyxoma and teratoma). This commentary will address current perspectives of prenatal sonography of the umbilical cord, including structural anomalies and the potential impact of future imaging technologies.
“…The diagnosis of fetal heart failure with prenatal ultrasound has been limited. Rapidly increasing polyhydramnios in the pump twin's compartment has also been suggested as a sign of high output fetal cardiac failure 6 . Ultrasound is necessary in the diagnosis and evaluation of this condition, as in this case.…”
SUMMARYTwin reversed arterial perfusion (TRAP) syndrome is an extremely rare manifestation of feto‐fetal transfusion syndrome. This condition is seen in monozygotic twin pregnancies, where the affected twin is perfused retrogradely by the healthy twin. The affected twin presents with bizarre malformations such as acardia and acephalus. We present such a case, which was diagnosed prenatally. The pregnancy progressed uneventfully to term.
“…An important role of MPR is in the treatment of complex twins, primarily TTTS, TRAPs [22], simultaneous intrauterine growth restriction (sIUGR), and other complex twinning complications.…”
Aim
To evaluate the theme trends and knowledge structure of multifetal pregnancy reduction (MPR)‐related literature by using bibliometric analysis.
Methods
Published scientific papers regarding MPR were retrieved from the PubMed database. Data extraction and statistics were conducted using Bibliographic Item Co‐Occurrence Matrix Builder (BICOMB). Furthermore, gCLUTO software was used in the study for bi‐clustering analysis and strategic diagram analysis.
Results
According to the search strategy, 906 total papers were included. Among all the extracted MeSH terms, 41 high frequency ones were identified and hotspots were clustered into four categories. In the strategic diagram, research on intrauterine treatment of MPR was most well developed. In contrast, statistical data on the sequelae of fetal reduction surgery and applications of MPR in assisted reproductive technologies were relatively immature.
Conclusion
The analysis of common terms among the high‐frequency network terms in multiparous pregnancy reduction can help researchers and clinicians understand the hotspots, key topics, and issues to be discovered on MPR. Research on intrauterine treatment of MPR was most well developed.
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