Twin Reversed Arterial Perfusion: To  Treat or Not?

Dubey, Sunita

doi:10.7860/jcdr/2017/24400.9140

Cited by 9 publications

(12 citation statements)

References 13 publications

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“…No existe consenso sobre qué método es el más adecuado debido a la escasa experiencia en el manejo de esta infrecuente situación [20][21][22][23][24][25][26][27] , pero se han utilizado diversas medidas terapéuticas prenatales, en especial, para reducir el exceso de líquido amniótico, que es frecuentemente el causante de la prematuridad (responsable de más de la mitad de la mortalidad) 11 .…”

Section: Resultsunclassified

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Gran feto acardio: diagnóstico tardío de gestacion gemelar monocorial biamniótica complicada por secuencia TRAP. Reporte de un caso y revisión de la literatura

Ruiz

Álvarez

Miyares

et al. 2021

Rev. chil. obstet. ginecol.

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Objectives: to report the case of a patient with a monochorionic-biamniotic twin gestation complicated by TRAP sequence that gave rise to the birth of a pump fetus without anatomical malformations (1932 g) and an acardiac anceps fetus (1800 g), and to review this pathology and the importance of its early diagnosis and management. Materials and methods: the case of an acardiac fetus is presented in a pregnant woman without strict control at the Hospital San Pedro de Logroño in 2019, worthwhile because of its late diagnosis and high birth weight. A search of the literature was carried out in the Medline databases via PubMed, OVID, Embase and SciELO with the MeSH terms. As inclusion criteria, we considered series-type articles and case reports, cohorts and review articles from January 1950 to January 2020. Results: 39 bibliographic references were included with the main theoretical questions to be reviewed. Our acardiac fetus weight was very high comparing with the bibiography and without causing repercussion in the healthy fetus, which contributes to the uniqueness of the case, only the series report by Brassard et al ( 1999) is comparable, with weights of the acardiac fetus above 1700 grams and differing by 100 grams from the pump fetus. Conclusions: the acardiac fetus is an infrequent complication of monochorionic twin pregnancies. The presence of placental vascular anastomoses between both circulations is required. Early diagnosis is important to decrease morbidity and to use, as far as possible, non-invasive therapeutic techniques.

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Section: Resultsunclassified

“…• Histerotomía selectiva. Existen casos aislados de histerotomías selectivas con extracción del feto acardio, algunas exitosas 21,22 .…”

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Gran feto acardio: diagnóstico tardío de gestacion gemelar monocorial biamniótica complicada por secuencia TRAP. Reporte de un caso y revisión de la literatura

Ruiz

Álvarez

Miyares

et al. 2021

Rev. chil. obstet. ginecol.

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“…In the largest series on the outcome of 49 acardiac twin pregnancies without intrauterine surgical treatment the mortality rate was 51% and only 24% of the patients delivered after 36 gestational weeks [6]. Other studies described a 50-70% mortality rate without adequate treatment [7,8].…”

Section: Discussionmentioning

confidence: 97%

Monochorionic-diamniotic twin pregnancy complicated by twin reversed arterial perfusion sequence and retroplacental hematoma – a case report

et al. 2018

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Twin reversed arterial perfusion (TRAP) sequence is a rare and severe complication specific to monochorionic twin pregnancies, involving the presence of an acardiac twin and a structurally normal co-twin (pump twin). We report on the case of a33-year-old female with a biamniotic monochorionic twin pregnancy complicated with TRAP sequence and polyhydramnios. The patient underwent fetoscopic termination of the acardiac twin and at 34 gestational weeks (GW) was readmitted with aretroplacental hematoma. The patient gave birth through caesarean section to a living female fetus, weighing 1480 g. To the best of our knowledge, this is the first case reporting a twin pregnancy with TRAP sequence complicated with retroplacental hematoma.

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“…One study pointed out that radiofrequency ablation (RFA) is an effective and safe treatment for TRAP, with a success rate of 71% 4 ; however, the optimal timing of RFA remains controversial 5–7 . Due to limited existing data, there is no uniform standard for the optimal management and expected treatment for TRAP 8 ; however, it is necessary to increase ultrasound monitoring during pregnancy 9 . In the present study, the blood supply was blocked due to spontaneous interruption of the umbilical cord of the acardiac twin, therefore the pump twin could grow normally.…”

Section: Figurementioning

confidence: 99%