TRAP (Twin Reversed Arterial Perfusion) sequence

Open Medicine ◽  
2014 ◽  
Vol 9 (3) ◽  
pp. 491-494
Author(s):  
Aleksandra Doronjski ◽  
Taita Stojilković ◽  
Slobodan Spasojević ◽  
Borko Milanović ◽  
Vesna Stojanović
Keyword(s):  
Serum Proteins ◽  
Myocardial Hypertrophy ◽  
Weight Ratio ◽  
Monozygotic Twin ◽  
Fetal Hydrops ◽  
Arterial Perfusion ◽  
Rare Malformation ◽  
Twin Pregnancies ◽  
Twin Reversed Arterial Perfusion ◽  
Pump Twin

AbstractTRAP (Twin Reversed Arterial Perfusion) sequence is a rare malformation that occurs in monozygotic twin pregnancies. Twin weight ratio in our case was 76% (body weight of pump twin was 1800 g, acardiac twin 1370 g), but in spite of that the pump twin had a mild clinical picture with premature birth, fetal hydrops (mild pleural effusion; hypoproteinemia; on the 3rd day of life the baby was without edema and the level of his serum proteins were in referral ranges) and mild myocardial hypertrophy of left ventricle (echocardiography performed on the 28th day of life was normal).

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 TRAP Sequence - An Interesting Entity in Twins

2012 ◽  
Vol 2 ◽  
pp. 56 ◽  
Author(s):  
R. H. Srinivas Prasad ◽  
T. Ramachandra Prasad ◽  
K. Dayananda Kumar
Keyword(s):  
Color Doppler ◽  
Color Doppler Imaging ◽  
Doppler Imaging ◽  
Arterial Perfusion ◽  
Prognostic Features ◽  
Trap Sequence ◽  
Rare Malformation ◽  
Twin Reversed Arterial Perfusion ◽  
Pump Twin

Twin reversed arterial perfusion (TRAP) sequence, is a rare malformation occurring in monozygotic multiple gestations. One well-developed normal (pump) twin and the other twin with absent cardiac structure (acardiac), who is hemodynamically dependent on the normal (pump) twin are characteristic of this syndrome. The acardiac twin develops multiple anomalies that make survival difficult. The prognosis of the pump twin is variable with mortality rate ranging from 50% to 70%. Complications that affect the prognosis of the pump twin include complications of congestive cardiac failure due to increased cardiac demand, prematurity secondary to preterm delivery, and polyhydramnios. Because of these complications prompt detection, follow-up, and treatment of this condition is very important. We report two cases of TRAP sequence that emphasizes the importance of gray-scale and color Doppler imaging in diagnosis, detection of poor prognostic features, follow-up, and management of TRAP sequence.

scholarly journals Acardius acephalus in a goat kid – radiological and gross findings: a case repor

2013 ◽  
Vol 58 (No. 11) ◽  
pp. 591-593
Author(s):  
F. Macri ◽  
G. Lanteri ◽  
S. Ferraro ◽  
G. Marino ◽  
G. Mazzullo
Keyword(s):  
Monozygotic Twin ◽  
Human Medicine ◽  
Radiological Findings ◽  
X Ray ◽  
Morphological Abnormalities ◽  
Arterial Perfusion ◽  
Twin Pregnancies ◽  
Black Goat ◽  
Twin Reversed Arterial Perfusion

We received a malformed Messinese Black goat foetus for examination. The foetus was part of a triple gestation, from which two male kids presented no morphological abnormalities and underwent regular slaughtering. X-ray examination and necropsy were performed. On the basis of gross and radiological findings the malformation was classified as acardius acephalus. In human medicine, acardius is a rare and severe abnormality reported as a unique complication of monozygotic twin pregnancies, and is known as twin-reversed arterial perfusion (TRAP).

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.

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

Microwave Ablation for Twin-Reversed Arterial Perfusion Sequence: A Novel Application of Technology

2015 ◽  
Vol 38 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Courtney D. Stephenson ◽  
Lorene A. Temming ◽  
Rebecca Pollack ◽  
David A. Iannitti
Keyword(s):  
Energy Source ◽  
Microwave Ablation ◽  
Rare Complication ◽  
Therapeutic Interventions ◽  
Vascular Connection ◽  
Arterial Perfusion ◽  
Risk Of Death ◽  
Microwave System ◽  
Twin Reversed Arterial Perfusion ◽  
Pump Twin

Introduction: Twin-reversed arterial perfusion sequence is a rare complication of monochorionic pregnancies that is characterized by the presence of an acardiac mass perfused by an apparently normal pump twin. The risk of death to the pump twin has led to a range of therapeutic interventions aimed at separating their vascular connection. We report a novel application of microwave ablation for vessel coagulation in the treatment of twin-reversed arterial perfusion sequence. Material and Methods: Microwave ablation has been adopted by surgical subspecialties as a superior energy source for vessel and tissue ablation as it creates heat without a circuit and has less thermal spread. We describe the use of a 2.45-GHz microwave system using a 1.8-mm antenna to coagulate the intra-abdominal portion of umbilical vessels of the acardiac mass. Results: We report 6 cases of twin-reversed arterial perfusion sequence treated by microwave ablation. All patients were treated with microwave ablation with successful coagulation of intra-abdominal umbilical cord vessels of the acardiac mass with cessation of flow. Discussion: Microwave ablation is an excellent energy source for vessel coagulation due to its thermal properties and can be used effectively in the treatment of twin-reversed arterial perfusion sequence.

MCMA acardiac twin: a trap?

2017 ◽  
Vol 6 (7) ◽  
pp. 3182
Author(s):  
Vinayachandran S. ◽  
Vedhapriya Sudhakar
Keyword(s):  
Rare Complication ◽  
Expectant Management ◽  
Monozygotic Twin ◽  
Arterial Perfusion ◽  
Acardiac Twin ◽  
Retrograde Perfusion ◽  
Arterial Anastomosis ◽  
Pump Twin

Acardiac twining or Twin Reverse Arterial Perfusion (TRAP) is a rare complication of monozygotic twin occurring due to retrograde perfusion of acardiac twin by structurally normal pump twin through abnormal arterio-arterial anastomosis in the placenta. Here we report a case of unexpected occurrence of acardiac twin diagnosed as monozygotic monoamniotic twin (MCMA) gestation with single foetal demise due to multiple anomalies, delivered vaginally suggesting a role for expectant management.

Twin Reversed Arterial Perfusion Syndrome

1998 ◽  
Vol 47 (2) ◽  
pp. 75-87 ◽  
Author(s):  
W. Malinowski ◽  
W. Wierzba
Keyword(s):  
Prenatal Diagnosis ◽  
High Risk ◽  
Twin Pair ◽  
Multiple Pregnancy ◽  
Cardiac Activity ◽  
Monochorionic Twin ◽  
Literature Research ◽  
Arterial Perfusion ◽  
Twin Pregnancies ◽  
Twin Reversed Arterial Perfusion

AbstractTwin reversed arterial perfusion (TRAP) syndrome is a rare but severe complication of monozygotic monochorionic twin pregnancies. The outcome is invariably fatal for the abnormal twins and for 50-75% of the normal co-twins. The prenatal diagnosis of the TRAP always has to be presumed in a multiple pregnancy within which a twin pair grows whenever cardiac activity can not be proved echographically. We present discuss – based upon literature research – pathogenic mechanisms, pathologic-anatomic, echographic diagnosis and management of these high-risk pregnancies.

Sign in / Sign up

Export Citation Format

Share Document