Twin reversed arterial perfusion sequence: A case report

Jiao, Yi; Wu, Xiumei

doi:10.1002/ijgo.13369

Cited by 1 publication

(2 citation statements)

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“…To the best of our knowledge, the diagnosis of acardia is almost always made in the second [17][18][19][20][21][22][23] or third trimester [24][25][26] of gestation by means of transabdominal ultrasound. In some cases, the existence of the TRAP Sequence could even remain unknown until delivery [27,28], when the childbirth is preceded or followed by ambiguous amorph mass expulsion.…”

Section: Diagnosismentioning

confidence: 99%

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“The Strange Case of Dr Pump and Mr Acardiac”: The Twin Reversed Arterial Perfusion (TRAP) Sequence in Two Monochorionic Monoamniotic (MCMA) Twin Pregnancies—Diagnosis, Prognosis and Management: Review of Literature

Nicolì,

Damiani,

Gaetani

et al. 2023

Diagnostics

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The Twin Reversed Arterial Perfusion (TRAP) Sequence is an extremely rare complication of monochorionic twin pregnancies, with one severely malformed twin (the “acardiac”) lacking autonomous placental blood supply and being perfused by the co-twin (the “pump”), through arterio-arterial (and sometimes also veno-venous) vascular anastomoses located on the placental surface. The prognosis is poor: mortality is 100% in the acardiac twin because of its severe malformations and about 50–55% in the pump twin, mainly due to heart failure and prematurity. So, the goal of perinatal management of the TRAP twin pregnancy is to deliver a healthy and near-term pump twin without heart failure or fetal hydrops. Intuitively, the earlier the diagnosis, the better the outcome. Herein, we report two cases of monochorionic monoamniotic (MCMA) twin pregnancies complicated by the TRAP Sequence, which are of interest since the objective of early diagnosis was achieved by means of transvaginal and 3D ultrasound, two techniques which revealed themselves as being useful to this purpose but are underused in the literature. The second aim of this study is to provide an overview of literature data about the diagnosis, prognosis establishment, and management of this rare condition, which are still debated and unclear due to negligible poor-quality evidence.

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Section: Diagnosismentioning

confidence: 99%

“…A spontaneous interruption of the vascular connection between the twins has been shown to occur [25,28,33,50], with the acardiac twin remaining smaller than the other one and the pump twin outcome being excellent [46].…”

Section: Twins' Vascular Disjunctionmentioning

confidence: 99%