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CC BY-NC-ND 4.0 · AJP Rep 2024; 14(03): e224-e227
DOI: 10.1055/a-2384-8058
Case Report

Rare Case of Twin Reversed Arterial Perfusion Acardius Acephalus Subtype Seen in a Community-Based Hospital

Laura Reguero Cadilla
1   Department of Obstetrics and Gynecology, Wyckoff Heights Medical Center, Brooklyn, New York
,
Carlos Villafuerte Santana
1   Department of Obstetrics and Gynecology, Wyckoff Heights Medical Center, Brooklyn, New York
,
Nicolle Centazzo
2   Department of Pediatrics, Wyckoff Heights Medical Center, Brooklyn, New York
,
Daniel Faustin
1   Department of Obstetrics and Gynecology, Wyckoff Heights Medical Center, Brooklyn, New York
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Abstract

Background TRAP sequence occurs in monochorionic pregnancies consisting of one normal fetus and a non-viable fetus. The pump twin has an increased risk of developing high-output cardiac failure.

Case 32-year-old G4P2012 with TRAP syndrome in current pregnancy presented to triage at 26 weeks with contractions and spotting. She had undergone RFA for selective reduction at another facility. Placental abruption was suspected and patient underwent a cesarean section. Twin A was delivered alive although she subsequently succumbed due to complications of prematurity.

Conclusion This case highlights the importance of early detection and consistent prenatal care in the management of TRAP sequence. Further research of interventions associated with improved outcomes should be encouraged.

Keywords

TRAP - complications - monochorionic monoamniotic twin - fetal


Publication History

Received: 07 April 2024

Accepted: 04 August 2024

Accepted Manuscript online:
12 August 2024

Article published online:
10 September 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Nicolì P, Damiani GR, Gaetani M. et al. “The Strange Case of Dr Pump and Mr Acardiac”: the twin reversed arterial perfusion (TRAP) sequence in two monochorionic monoamniotic (MCMA) twin pregnancies-diagnosis, prognosis and management: review of literature. Diagnostics (Basel) 2023; 13 (19) 3109
    CrossrefPubMedSearch in Google Scholar
  • 2 Hans P. Twin reversed arterial perfusion. Cureus 2022; 14 (11) e31116
    PubMedSearch in Google Scholar
  • 3 Moore TR, Gale S, Benirschke K. Perinatal outcome of forty-nine pregnancies complicated by acardiac twinning. Am J Obstet Gynecol 1990; 163 (03) 907-912
    CrossrefPubMedSearch in Google Scholar
  • 4 Guimaraes CV, Kline-Fath BM, Linam LE, Garcia MA, Rubio EI, Lim FY. MRI findings in multifetal pregnancies complicated by twin reversed arterial perfusion sequence (TRAP). Pediatr Radiol 2011; 41 (06) 694-701
    CrossrefPubMedSearch in Google Scholar
  • 5 Bonilla-Musoles F, Machado LE, Raga F, Osborne NG. Fetus acardius: two- and three-dimensional ultrasonographic diagnoses. J Ultrasound Med 2001; 20 (10) 1117-1127
    CrossrefPubMedSearch in Google Scholar
  • 6 Lee H, Bebbington M, Crombleholme TM. North American Fetal Therapy Network. The North American Fetal Therapy Network Registry data on outcomes of radiofrequency ablation for twin-reversed arterial perfusion sequence. Fetal Diagn Ther 2013; 33 (04) 224-229
    CrossrefPubMedSearch in Google Scholar
  • 7 Li N, Sun J, Wang J. et al. Selective termination of the fetus in multiple pregnancies using ultrasound-guided radiofrequency ablation. BMC Pregnancy Childbirth 2021; 21 (01) 821
    CrossrefPubMedSearch in Google Scholar
  • 8 Buyukkaya A, Tekbas G, Buyukkaya R. Twin reversed arterial perfusion (TRAP) sequence; characteristic gray-scale and Doppler ultrasonography findings. Iran J Radiol 2015; 12 (03) e14979
    CrossrefPubMedSearch in Google Scholar
  • 9 Weber EC, Strizek B, Recker F. et al. Outcome of monochorionic pregnancies after selective feticide with bipolar cord coagulation: a German single center experience. J Clin Med 2022; 11 (06) 1516
    CrossrefPubMedSearch in Google Scholar