TRAP sequence; case report

2021 ◽  
pp. 110-112
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Poor Prognosis ◽  
High Flow ◽  
Obstetrics And Gynecology ◽  
Monochorionic Twin ◽  
Trap Sequence ◽  
Training And Research ◽  
Twin Pregnancies ◽  
Pump Twin

TRAP sequence is a syndrome with poor prognosis seen in monochorionic twin pregnancies at the rate of 1/100. There is an acardiac “nonviable” fetus with multiple anomalies in the TRAP sequence and a pump fetus feeding this fetus through vascular anastomoses in the placenta. Mortality for acardiac twins is 100%. The mortality of the pump twin is around 50%, and death may be generally due to high flow rate heart failure and sometimes prematurity caused by polyhydramnios. Here, we presented an acardiac acephalous type TRAP case that applied to the Obstetrics and Gynecology Clinic of Amasya University Sabuncuoğlu Şerefeddin Training and Research Hospital. The case was 30 years old. The patient had the first pregnancy and reached this pregnancy with the IVF method. She did not have any disease. During the measurement of NT, the fetus of acardiac acephalous type was detected. Laser ablation was performed at the outer center at 18 weeks. All subsequent follow-ups were done by our center. While the patient had 39 weeks and 2 days of pregnancy, the pregnancy was terminated by performing cesarean due to primipara breech arrival.

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

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 Is it correct to trust each ultrasonography report blindly? a case report on misdiagnosis, diagnosis and management of acardiac twin pregnancy

2020 ◽  
Vol 9 (6) ◽  
pp. 2628
Author(s):  
Pooja Chandak ◽  
Shobha Toshniwal
Keyword(s):  
Case Report ◽  
Twin Pregnancy ◽  
Rare Complication ◽  
Fetal Medicine ◽  
Monochorionic Twin ◽  
Arterial Perfusion ◽  
Acardiac Twin ◽  
Risk Pregnancy ◽  
Twin Pregnancies ◽  
Multifetal Pregnancy

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.

scholarly journals Fetal Intra-Peritoneal Transfusion for the Management of Very Early Spontaneous Twin Anemia-Polycythemia Sequence in an Obese Patient With a Whole Anterior Placenta

2016 ◽  
Vol 19 (2) ◽  
pp. 154-157 ◽  
Author(s):  
Cécile Guenot ◽  
Romaine Robyr ◽  
Nicole Jastrow ◽  
Yvan Vial ◽  
Luigi Raio ◽  
...  
Keyword(s):  
Case Report ◽  
Obese Patient ◽  
Laser Surgery ◽  
Rare Condition ◽  
Curative Treatment ◽  
Monochorionic Twin ◽  
Complicated Conditions ◽  
Twin Pregnancies ◽  
High Bmi

Twin anemia-polycythemia sequence (TAPS) is a rare condition in monochorionic twin pregnancies. Small intertwin placental vascular communications allow transfusion, which results in a hemoglobin difference in the twins in the absence of oligohydramnios or polyhydramnios. We report here a case of TAPS diagnosed at 17 weeks’ gestation in an obese patient (BMI 42) with a whole anterior placenta. The only possible treatment at this stage of pregnancy was intra-uterine transfusion (IUT), which was repeated weekly until photocoagulation of placental anastomoses was feasible. Fetoscopic laser surgery is the only curative treatment, but is challenging in TAPS because of the absence of polyhydramnios and the presence of minuscule anastomoses. An anterior placenta and high BMI can make the procedure even more challenging. This case report demonstrates that very early and rapidly progressing TAPS with technically complicated conditions (elevated BMI and anterior placenta) can be successfully managed with IUT until laser procedure is achievable.

scholarly journals TWIN REVERSED ARTERIAL PERFUSION SEQUENCE (TRAP);

2017 ◽  
Vol 24 (07) ◽  
pp. 1093-1095
Author(s):  
Mubasher Saeed Pansota ◽  
Muhammad Imran Niaz
Keyword(s):  
Case Report ◽  
Cardiac Failure ◽  
Twin Pregnancy ◽  
Identical Twins ◽  
The Other ◽  
Arterial Perfusion ◽  
Trap Sequence ◽  
Cardiac System ◽  
Twin Reversed Arterial Perfusion ◽  
Pump Twin

Twin reversed arterial perfusion sequence (TRAP sequence) is a condition thatoccurs only in identical twins that share a placenta (monochorionic), in which one twin lackinga functioning cardiac system “acardiac monster” receives blood from the normally developingtwin called the “pump twin”. This places an enormous demand on the heart putting the pumptwin at risk for cardiac failure. Left untreated, the pump twin will die in 50 percent to 75 percentof cases. Here we present the case report of a 20 years old G2P1at 32 weeks POG with amonochorionic twin pregnancy. One of the twins was “acardiac acephalous” and the other a“pump twin” with mild hydrocephalous.

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.

Twin-to-twin transfusion syndrome and limb ischemia: a case report

2012 ◽  
Vol 1 (1-2) ◽  
Author(s):  
Richard Alexander Hollander ◽  
Dirk Puylaert ◽  
Kristof Fabry ◽  
Anne Debeer ◽  
Liesbeth Lewi ◽  
...  
Keyword(s):  
Case Report ◽  
Amniotic Fluid ◽  
High Mortality ◽  
Laser Photocoagulation ◽  
Limb Ischemia ◽  
Severe Complication ◽  
Monochorionic Twin ◽  
Twin Pregnancies

AbstractTwin-to-twin transfusion syndrome (TTTS) is a severe complication of monochorionic twin pregnancies. This condition is associated with high mortality if untreated. Treatment consists of either serial reduction of amniotic fluid or selective laser photocoagulation (SLP).

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.

Twin–to–twin transfusion syndrome: a case report. Antepartum prediction of underlying placental vascular pattern in monochorionic twin pregnancies may be possible

1999 ◽  
Vol 2 (4) ◽  
pp. 286-289
Author(s):  
Hans A Zondervan ◽  
Martin JC van Gemert ◽  
Peter JG Nikkels ◽  
Annemieke Omtzigt ◽  
Martin Offringa ◽  
...  
Keyword(s):  
Case Report ◽  
Vascular Pattern ◽  
Monochorionic Twin ◽  
Twin Pregnancies
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