scholarly journals A rare complication of monochorionic twin pregnancy: Twin-reversed arterial perfusion (TRAP) sequence

2015 ◽  
Vol 71 ◽  
pp. S114-S115 ◽  
Author(s):  
Meenakshi K. Bharadwaj ◽  
N. Mohana Priya
Folia Medica ◽  
2014 ◽  
Vol 56 (2) ◽  
pp. 129-132
Author(s):  
Georgi I. Amaliev ◽  
Maria L. Malinova ◽  
Blagovest K. Pehlivanov ◽  
Hristina A. Ivancheva

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.


2018 ◽  
Vol 20 (3) ◽  
pp. 396
Author(s):  
Andrei Mihai Malutan ◽  
Marina Dudea ◽  
Camelia Albu ◽  
Razvan Ciortea ◽  
Doru Diculescu ◽  
...  

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.


2020 ◽  
Vol 32 (2) ◽  
pp. 143-144
Author(s):  
Parvez Ahmed ◽  
Nasrin Begum ◽  
Mostofa Shamim Ahsan ◽  
Mosharruf Hossain ◽  
Munshi Md Arif Hosen ◽  
...  

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


Author(s):  
Lyn Z. A. Rabetsimamanga ◽  
Hary F. Rabarikoto ◽  
Maheriandrianina F. V. Rajaonarivony ◽  
Setriny M. Ravoavy ◽  
Hery R. Andrianampanalinarivo

TRAP syndrome is a rare complication of monochorionic twin pregnancy. It is characterized by the association of an acardiac twin with a healthy twin. The acardiac twin is a parasite who put the healthy twin at high risk of cardiac failure. We report a case in a 25-year-old Malagasy woman, primigravida, who had a consultation at gestational week 31 for significant dyspnea and a threat of premature delivery. Ultrasound scans discovered an acute polyhydramnios, fetus with anasarca and low cardiac activity, and a para-fetal mass. She gives birth to a male newborn and an acardiac twin without head an upper body. The first twin died short time after birth.


Author(s):  
Pooja Chandak ◽  
Shobha Toshniwal

Multifetal gestation is often a high-risk pregnancy and especially the monochorionic twin pregnancy significantly contributes to fetal morbidity and mortality. Acardiac twinning, earlier known as chorioangiopagus parasiticus, is the most extreme manifestation of this condition. An acardiac twin is a rare complication of multifetal pregnancy, in the literature reported at an incidence of 1% of monochorionic twin pregnancies, i.e. 1 of 35,000 pregnancies. Often results from abnormal placental vascular anastomoses. This leads to twin reversal arterial perfusion with complex pathophysiology. Here authors present a case of acardiac twin pregnancy presented at 26 weeks with the ultrasonography report suggested?? Placental teratoma of size 11×11×13 cm with polyhydramnios as there was no reason to suspect something else as the picture described in the USG report with the polyhydramnios was fitting with the diagnosis of placental teratoma but as the scan was done at taluka place and the images provided were not clear authors decided to confirm the diagnosis from fetal medicine specialist as MTP was not the option for the patient as she was 28 weeks who confirmed that as a case of acardiac twin pregnancy and the case was managed accordingly.


Author(s):  
Abolfazl Abouie ◽  
Nima Rakhshankhah ◽  
Ladan Younesi ◽  
Zeinab Safarpour ◽  
Ayda Roostaee ◽  
...  

Abstract Background Twin reversed arterial perfusion sequence (TRAP) is a very rare congenital anomaly. We present sonographic findings of TRAP sequence in the case of a multiparous woman with a monochorionic monoamniotic twin pregnancy who was referred to our unit for blood sugar control. Case presentation The patient had a history of co-twin demise at 13 weeks of gestation without appropriate fetal surveillance afterwards. We found a monochorionic placentation with a normal appearing pump twin, an abnormal appearing co-twin without obvious cardiac activity and reversed arterial flow toward instead of away from the anomalous acardiac fetus. Therefore, the sonographic diagnosis of TRAP sequence was confirmed. Conclusions We recommend considering the potential rare complications of monochorionic twin pregnancy which necessitates proper surveillance and intervention to monitor suitable growth of pump twin.


Author(s):  
Shazia Khan ◽  
Tina Singh ◽  
Gunadhar Maiti

Twin reversed arterial perfusion (TRAP) sequence is an extremely rare complication of monochorionic multi-foetal pregnancy, occurring once in 35,000 births. It is characterized by a malformed foetus without a heart being perfused by a structurally normal (pump) twin via an artery-to-artery anastomosis in a reverse direction. We report one such case where ultrasound imaging revealed monochorionic twin pregnancy with a viable, normal-appearing first twin and a structurally aberrant second twin with absent cardiac activity. The patient was monitored with two weekly ultrasonography and Doppler ultrasound examination to ascertain the well-being of the pump twin. She delivered successfully at term a normal live baby and an acardius anceps foetus. The perinatal mortality of the pump twin ranges from 35 to 55%; making it essential to diagnose the presence of a pump twin at an early gestational age through improved imaging techniques to plan effective intervention at appropriate time.


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