scholarly journals ‘TRAP-ped with an Acardius’: Case Series of Twin Reversed Arterial Perfusion (TRAP) Sequence and Review of Literature

2021 ◽  
Vol 8 (1) ◽  
pp. 27-33
Author(s):  
Philipp Quaas ◽  
Filiz Markfeld-Erol
Keyword(s):  
Clinical Course ◽  
Heart Function ◽  
Case Series ◽  
Review Of Literature ◽  
Severe Condition ◽  
Arterial Perfusion ◽  
Trap Sequence ◽  
Twin Pregnancies ◽  
Twin Reversed Arterial Perfusion ◽  
Normal Twin

AbstractTwin reversed arterial perfusion (TRAP) sequence is a rare but severe condition that affects monochorionic (MC) multifetal pregnancies. In twin pregnancies, it is characterized by a normally developed twin and another twin with missing heart function (acardiac twin or TRAP twin). A variety of risks and complications may affect the normal twin. Management of such pregnancies can be either expectant or interventional. We report four cases of TRAP sequence treated in our institutions and supply an overview on currently existing literature. This case series demonstrates the heterogeneity in manifestations and clinical course of patients affected by this condition. Furthermore, it includes an acardius amorphous of considerable size delivered at 35.6 weeks of gestation.

Radiofrequency Ablation with an Internally Cooled Electrode for Twin Reversed Arterial Perfusion Sequence

2016 ◽  
Vol 40 (2) ◽  
pp. 110-115 ◽  
Author(s):  
Maiko Wagata ◽  
Takeshi Murakoshi ◽  
Keisuke Ishii ◽  
Jin Muromoto ◽  
Jun Sasahara ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Color Doppler ◽  
Fetal Demise ◽  
Arterial Perfusion ◽  
Trap Sequence ◽  
Internally Cooled ◽  
Gestational Age At Delivery ◽  
Twin Pregnancies ◽  
Twin Reversed Arterial Perfusion ◽  
Pump Twin

Objective: The study aims to evaluate the efficacy of radiofrequency ablation (RFA) with an internally cooled electrode for twin reversed arterial perfusion (TRAP) sequence. Methods: From April 2008 through December 2014, we retrospectively reviewed all patients who underwent RFA with an internally cooled electrode for TRAP sequence at 3 tertiary referral centers in Japan. Results: Twenty-five monochorionic diamniotic twin pregnancies underwent RFA with an internally cooled electrode for TRAP sequence at 16-27 weeks of gestation. In all cases, umbilical cord blood flow cessation in the acardiac twin was confirmed by ultrasonography with color Doppler. There were 2 cases of procedure-related complications: 1 case of unintentional septostomy and 1 case of anemia in a pump twin. Fetal demise of the pump twin occurred in 3 (12%) cases. Twenty-two (88%) of 25 pump twins were delivered alive. The median gestational age at delivery was 36 + 3 weeks (range 25 + 2-40 + 5 weeks). There were 14 cases (64%) of premature deliveries before 37 weeks and 5 (23%) before 32 weeks. Conclusion: RFA with an internally cooled electrode is a feasible and effective procedure for the treatment of TRAP sequence.

scholarly journals A Case of Trap Sequence with Immense Acardiac Twin

Folia Medica ◽  
2014 ◽  
Vol 56 (2) ◽  
pp. 129-132
Author(s):  
Georgi I. Amaliev ◽  
Maria L. Malinova ◽  
Blagovest K. Pehlivanov ◽  
Hristina A. Ivancheva
Keyword(s):  
Twin Pregnancy ◽  
Rare Complication ◽  
Arterial Perfusion ◽  
Acardiac Twin ◽  
Trap Sequence ◽  
Complicated Pregnancy ◽  
Twin Reversed Arterial Perfusion ◽  
Normal Twin ◽  
Pump Twin

Abstract Twin-reversed arterial perfusion sequence is a rare complication of monochorionic twin pregnancy in which an anomalous acardiac fetus is hemodynamically dependent on its structurally normal “pump” twin. Early diagnosis is essential for improving perinatal prognosis for the normal twin. In this case report we present a case of TRAP sequence with immense acardiac twin with favorable outcome, emphasizing the importance of ultrasound imaging, follow-up and timing of delivery in this complicated pregnancy.

scholarly journals Acardiac-acephalus Twinning- A Very Rare Case Report

2020 ◽  
Vol 32 (2) ◽  
pp. 143-144
Author(s):  
Parvez Ahmed ◽  
Nasrin Begum ◽  
Mostofa Shamim Ahsan ◽  
Mosharruf Hossain ◽  
Munshi Md Arif Hosen ◽  
...  
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Severe Form ◽  
Monochorionic Twin ◽  
Arterial Perfusion ◽  
Trap Sequence ◽  
Rare Case Report ◽  
Medicine Today ◽  
Twin Pregnancies ◽  
Twin Reversed Arterial Perfusion

Introduction:This study highlights a very rare case which was related to abnormal monochorionic twinning status. Case Report: This case (a 28 year old pregnant woman) came at this institute for ultrasonographic evaluation of herpregnancy status. Her ultrasonographic results were consistent with acardiac-acephalus twinning condition (which isalso known as, twin reversed arterial perfusion or TRAP sequence). Discussion: This monochorionic twin pregnancy isa severe form of twin-to-twin transfusion syndrome (TTTS) and severe TTTS has mortality rate of about 60–100%. Conclusion: This case is very rare showing prevalence of about 1/35,000 overall pregnancies and accounting 1.0% ofthe monochorionic twin pregnancies. Medicine Today 2020 Vol.32(2): 143-144

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.

scholarly journals Twin reversed arterial perfusion (TRAP) sequence – a case report and review of literature

2015 ◽  
Vol 8 (3) ◽  
pp. 307
Author(s):  
NawalM Hubaishi ◽  
Fatima Cherifi ◽  
Azza Elsayed ◽  
Farida Adam
Keyword(s):  
Case Report ◽  
Review Of Literature ◽  
Arterial Perfusion ◽  
Trap Sequence ◽  
Twin Reversed Arterial Perfusion

scholarly journals An incidental rare finding of a TRAP sequence during a caesarean section: A case report

2021 ◽  
Vol 8 (2) ◽  
pp. 264-266
Author(s):  
Shivangi Sharma ◽  
Minal Choudhary
Keyword(s):  
Caesarean Section ◽  
Upper Body ◽  
Arterial Perfusion ◽  
Acardiac Twin ◽  
Trap Sequence ◽  
Arterial Anastomosis ◽  
Umbilical Arteries ◽  
Twin Pregnancies ◽  
Normal Twin ◽  
Pump Twin

Twin reversed arterial perfusion (TRAP) sequence is an anomaly of monochorionic twin pregnancies where one twin has an absent, non-functioning or rudimentary heart while the other twin may be normal. The condition occurs because of early development of arterio -arterial anastomoses between the umbilical arteries of twin foetuses that share a fused placenta. In this condition, the affected anomalous (acardiac twin) is perfused by the normal twin (pump twin) via an arterio-arterial anastomosis. The affected twin (acardiac twin) presents with malformations such as absent (acradia) or rudimentary heart, underdeveloped or missing head, upper body and limbs. As pump twin has to provide circulation to itself as well as the perfused twin, this increased burden to perfuse acardiac twin increases the risk of developing cardiac failure in pump twin. Here we present such a case of 22-year-old, which was diagnosed per operatively during caesarean section at department of obstetrics & gynecology, Rukshamaniben General Hospital, Ahmedabad.

TRAP) Secuencia de perfusión arterial reversa en embarazo gemelar monocoriónico con feto acárdico. Caso Clínico.

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Edwin Vargas Llerena ◽  
Severino Rey ◽  
German Herrera ◽  
Alexandra Robayo
Keyword(s):  
English Literature ◽  
Perinatal Outcomes ◽  
It Management ◽  
Second Trimester ◽  
Arterial Perfusion ◽  
Acardiac Twin ◽  
Trap Sequence ◽  
Twin Reversed Arterial Perfusion ◽  
Normal Twin ◽  
Made In

Objetive: Develop a review of the pathophysiology, diagnosis, treatment and management of reversed arterial perfusion.The reversed arterial perfusion sequence, known in English literature as TRAP sequence (twin reversed arterial perfusion (1), pathology associated with complications of monochorionic twin pregnancy, (2) is the absence of a well-defined cardiac structure on a twin (the acardiac twin), which is kept alive by his co-twin (the pump twin) through an arterial-arterial surface placental anastomosis. (3) the normal twin accompanying the acardiac has a mortality of 60% ; morbidity is mainly associated with congestive heart failure (4) while the acardiac twin has a mortality of 100% Apropos of a case reversed arterial perfusion syndrome TRAP diagnosed in the second trimester of pregnancy will be displayed and evaluate it. Management made in the service of Gynecology, service image and Pathology service and the associated perinatal outcomes. Keywords: acardic Fetus, perfusion sequence reversed arterial, sequence TRAP, monochorionic pregnancy twin

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

2018 ◽  
Vol 20 (3) ◽  
pp. 396
Author(s):  
Andrei Mihai Malutan ◽  
Marina Dudea ◽  
Camelia Albu ◽  
Razvan Ciortea ◽  
Doru Diculescu ◽  
...  
Keyword(s):  
Twin Pregnancy ◽  
Female Fetus ◽  
Monochorionic Twin ◽  
Arterial Perfusion ◽  
Acardiac Twin ◽  
Trap Sequence ◽  
First Case ◽  
Retroplacental Hematoma ◽  
Twin Pregnancies ◽  
Twin Reversed Arterial Perfusion

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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