P23.15: Monochorionic triamniotic triplet pregnancy complicated by twin reversed arterial perfusion (TRAP) sequence

2012 ◽  
Vol 40 (S1) ◽  
pp. 259-259
Author(s):  
J. Kuran ◽  
C. Niszczota ◽  
A. Kolesnik ◽  
J. H. Dangel
Keyword(s):  
Triplet Pregnancy ◽  
Arterial Perfusion ◽  
Trap Sequence ◽  
Twin Reversed Arterial Perfusion

Intrafetal Laser Coagulation for Trap Sequence in a Complicated Dichorionic Triamniotic Triplet Pregnancy Case Report and Review of the Literature

2017 ◽  
Vol 10 (2) ◽  
pp. 146-150
Author(s):  
Petya P. Chaveeva ◽  
Slavcho T. Tomov ◽  
Atanas D. Shterev
Keyword(s):  
Pregnancy Outcome ◽  
Color Doppler ◽  
First Trimester ◽  
Laser Coagulation ◽  
Triplet Pregnancy ◽  
Vitro Fertilization ◽  
Arterial Perfusion ◽  
Trap Sequence ◽  
Twin Reversed Arterial Perfusion

Summary A rare case is reported of twin-reversed arterial perfusion (TRAP) sequence in a triplet pregnancy, fetal intervention in the first trimester and pregnancy outcome. We report a case of TRAP sequence complication in dichorionic triamniotic triplet pregnancy, with a normally developing fetus and an acardiac fetus connected via arterio-arterial anastomoses in a monochorionic diamniotic twin pair and a separate fetus. TRAP sequence was diagnosed at 13 weeks in triplet pregnancy after in vitro fertilization (IVF) and embryo transfer of two blastocysts. Color Doppler assessment showed persistent arterial flow in the acardiac twin. Intrafetal laser coagulation was carried out at the time of the diagnosis, and the pregnancy outcome was two survivals at 36.4 weeks of gestation.

scholarly journals A Case of Monochorionic-Triamniotic Triplet Pregnancy with TRAP Sequence Successfully Treated with Radiofrequency Ablation with a Parallel Circuit Consisting of Anastomosed Blood Vessels between the Direct Pump Fetus and the Indirect Pump Fetus

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Shusaku Kobori ◽  
Masatake Toshimitsu ◽  
Shinichi Nagaoka ◽  
Jun Murotsuki
Keyword(s):  
Radiofrequency Ablation ◽  
Blood Vessels ◽  
Multiple Pregnancy ◽  
Triplet Pregnancy ◽  
Arterial Perfusion ◽  
Trap Sequence ◽  
Parallel Circuit ◽  
Twin Pregnancies ◽  
Direct Pump ◽  
Twin Reversed Arterial Perfusion

Monochorionic-triamniotic triplet pregnancy with twin reversed arterial perfusion (TRAP) sequence is one of the rare complications of multiple pregnancy and has been reported by only a few. Here, we report a case of monochorionic-triamniotic triplet pregnancy with TRAP sequence successfully treated with radiofrequency ablation, which did not develop polyhydramnios and heart failure although the estimated weight of the acardiac fetus increased twice as much as that of the direct pump fetus. Interestingly, the anastomosed blood vessels between the direct and indirect pump fetuses comprised a parallel circuit, which provided blood flow to the acardiac fetus. We hypothesized that the burden on the pump fetus in monochorionic pregnancy with TRAP sequence would be different between triplet and twin pregnancies.

Acardius in a Triplet Pregnancy: Cytogenetic and Morphological Profile

1992 ◽  
Vol 41 (1) ◽  
pp. 27-32 ◽  
Author(s):  
I.I. Bolaji ◽  
G. Mortimer ◽  
F.P. Meehan ◽  
S. England ◽  
M. Greally
Keyword(s):  
Caesarean Section ◽  
Cytogenetic Analysis ◽  
Rare Case ◽  
Chromosomal Abnormalities ◽  
Triplet Pregnancy ◽  
Genetic Theory ◽  
Arterial Perfusion ◽  
Trap Sequence ◽  
Structural Abnormalities ◽  
Twin Reversed Arterial Perfusion

AbstractWe describe a rare case of acardius in a triplet pregnancy terminated by Caesarean Section at 32 weeks gestation. Morphological and chromosomal abnormalities of the fetus as well as structural abnormalities of the placenta are presented. Cytogenetic analysis and examination of the single disc triplet placenta provide evidence for the two major theories of pathogenesis of acardius, the twin reversed arterial perfusion (TRAP) sequence and the genetic theory, which we believe are not necessarily mutually exclusive.

Prenatal surgery in a triplet pregnancy complicated by a double twin reversed arterial perfusion (TRAP) sequence

2012 ◽  
Vol 1 (1-2) ◽  
Author(s):  
Maria-Elisabeth Smet ◽  
Dirk Smet ◽  
Philip DeKoninck ◽  
Luc De Catte ◽  
Jan Deprest ◽  
...  
Keyword(s):  
Normal Growth ◽  
First Trimester ◽  
Baby Girl ◽  
Triplet Pregnancy ◽  
Arterial Perfusion ◽  
Trap Sequence ◽  
First Case ◽  
Umbilical Cords ◽  
Twin Reversed Arterial Perfusion ◽  
Double Twin

AbstractTo the best of our knowledge, we report the first case of a successful antenatal intervention in a double twin reversed arterial perfusion (TRAP) sequence in a monoamniotic monochorial triplet pregnancy. After diagnosis during first-trimester ultrasound, fetoscopic coagulation and transection of the umbilical cords of both acardiac members was performed at 16 weeks of gestation. The immediate postoperative course was complicated with iatrogenic preterm premature rupture of membranes, which was successfully reversed with an amniopatch procedure. Consequent sonographic assessments showed a healthy fetus with normal growth and development, together with progressive atrophy of the acardiac fetuses. Owing to placental abruption, an urgent cesarean section was performed at 32 weeks. A baby girl of 1600 g was born in good general condition. Except for the butts of the transected umbilical cords, there were no remnants of the TRAP twins to be distinguished. After a neonatal follow up of 64 days, the baby girl could be discharged.

scholarly journals Monochorionic-Triamniotic Triplet Pregnancy Complicated by Twin Reversed Arterial Perfusion Sequence: Case Report and Literature Review

2017 ◽  
Vol 07 (02) ◽  
pp. e106-e110 ◽  
Author(s):  
Pingshan Pan ◽  
Guoyang Luo ◽  
Lu Tang ◽  
Jeanne Rolle ◽  
Yuqin Qin ◽  
...  
Keyword(s):  
Preterm Labor ◽  
Umbilical Artery ◽  
Ductus Arteriosus ◽  
Triplet Pregnancy ◽  
Arterial Perfusion ◽  
Preterm Premature Rupture ◽  
Trap Sequence ◽  
Vascular Connections ◽  
Twin Reversed Arterial Perfusion ◽  
Selective Fetal Reduction

Background Monochorionic-triamniotic pregnancies are rare and fraught with complications. Case A case of monochorionic-triamniotic triplet pregnancy complicated by twin reversed arterial perfusion (TRAP) sequence is presented. The patient declined termination or selective fetal reduction. Triplet C was acardiac. At 24 weeks, triplet B developed polyhydramnios. At 30 weeks, polyhydramnios was seen in all three amniotic sacs, but without signs of fetal hydrops and with normal Doppler velocimetry measurements in the umbilical artery, middle cerebral artery, and ductus arteriosus of triplets A and B. At 322/7 weeks, the patient presented with preterm premature rupture of membranes and preterm labor. Two live male infants were delivered by cesarean delivery weighing 1,350 and 1,390 g, respectively; the acardiac fetus weighed 1,460 g. Pathology examination revealed a single placenta weighing1,250 g, with evidence of direct vascular connections between triplets A and C as well as between triplets A and B. Conclusion Monochorionic-triamniotic triplet pregnancy with TRAP sequence is rare. Although the risk of complications is high, such pregnancies can be managed conservatively in select cases.

Twin-Reversed Arterial Perfusion Sequence in a Triple Monochorionic Pregnancy with Two Direct Pump Fetuses Results in Significant Cyclic Doppler Waveform

2014 ◽  
Vol 37 (2) ◽  
pp. 157-160 ◽  
Author(s):  
Rocío López-Pérez ◽  
Mónica Lorente ◽  
Juan Martínez-Uriarte ◽  
Inmaculada M. Rivero ◽  
Olivia García-Izquierdo ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Doppler Ultrasound ◽  
Arterial Perfusion ◽  
Trap Sequence ◽  
Doppler Waveform ◽  
Waveform Pattern ◽  
Direct Pump ◽  
Twin Reversed Arterial Perfusion ◽  
Pump Twin

We report a case of a twin-reversed arterial perfusion (TRAP) sequence complication in monochorionic triplets, in which both normal fetuses were directly connected to the umbilical cord of the acardiac fetus, thus both acting as a pump twin. Doppler ultrasound showed a significant waveform pattern with two superposed systolic waveforms in the same vessel. After birth, placental findings confirmed the existence of two direct pump twins. The Doppler pattern described here may be of help to distinguish the existence of two pump twins in a triplet monochorionic pregnancy with TRAP.

Twin reversed arterial perfusion (TRAP) sequence managed at 11+6 weeks with radiofrequency ablation

2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Gwangjun Kim ◽  
Min Young Park ◽  
Seung Su Han
Keyword(s):  
Case Report ◽  
Radiofrequency Ablation ◽  
Gestational Age ◽  
Feeding Artery ◽  
First Line ◽  
Arterial Perfusion ◽  
Trap Sequence ◽  
Twin Reversed Arterial Perfusion ◽  
Line Management

AbstractRadiofrequency ablation (RFA) has become widely accepted as first-line management for twin reversed arterial perfusion (TRAP) sequence. Most RFA procedures have been performed using RFA needles of 14–17 gauge (G) focusing on an acardiac mass at an average age of 21 weeks of gestation (17–24 weeks). In this case report, we describe treatment of TRAP sequence using RFA with a 20 G needle focusing a feeding artery on the placental surface at gestational age of 11+6.

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