Twin Reversed Arterial Perfusion Sequence Diagnosed Late in the Third Trimester: A Case Report and Literature Review
ABSTRACT The twin reversed arterial perfusion (TRAP) sequence is a rare complication associated with monochorionic twins. It is characterized by blood flow from the umbilical artery of the normal (pump) twin to the umbilical artery of the abnormal (acardiac) twin via artery‐to‐artery anastomosis. Th...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | Clinical Case Reports |
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| Online Access: | https://doi.org/10.1002/ccr3.70052 |
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| author | Tafese Dejene Abdi Kebede Getahun Fetensa Delayehu Bekele Telila Mesfin Kelil Hussen |
| author_facet | Tafese Dejene Abdi Kebede Getahun Fetensa Delayehu Bekele Telila Mesfin Kelil Hussen |
| author_sort | Tafese Dejene |
| collection | DOAJ |
| description | ABSTRACT The twin reversed arterial perfusion (TRAP) sequence is a rare complication associated with monochorionic twins. It is characterized by blood flow from the umbilical artery of the normal (pump) twin to the umbilical artery of the abnormal (acardiac) twin via artery‐to‐artery anastomosis. This condition is associated with 100% mortality in the acardiac twin and a high rate of perinatal morbidity and mortality in the pump twin, primarily due to intrauterine hypoxic injury, heart failure, and prematurity. Following delivery, the surviving pump twin may experience adverse neurodevelopmental outcomes and heart failure, necessitating ongoing follow‐up care. The goal of managing pregnancies complicated by the TRAP sequence is to deliver a healthy, near‐term pump twin through early detection, timely intervention, and continuous follow‐up. However, in low‐resource settings, such as the case presented here, the condition may progress undiagnosed into the third trimester due to a lack of experienced physicians and/or obstetric ultrasound scans. This case report serves as an entry point for a comprehensive review of the literature on management options for the TRAP sequence, specifically focusing on factors to consider when managing patients conservatively in resource‐limited environments or in cases that are referred or diagnosed late. |
| format | Article |
| id | doaj-art-063fa4373ab647a9893207a0fa8d9f34 |
| institution | Kabale University |
| issn | 2050-0904 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj-art-063fa4373ab647a9893207a0fa8d9f342025-01-24T05:08:46ZengWileyClinical Case Reports2050-09042025-01-01131n/an/a10.1002/ccr3.70052Twin Reversed Arterial Perfusion Sequence Diagnosed Late in the Third Trimester: A Case Report and Literature ReviewTafese Dejene0Abdi Kebede1Getahun Fetensa2Delayehu Bekele3Telila Mesfin4Kelil Hussen5College of Medicine and Health Sciences Dire Dawa University Dire Dawa EthiopiaDilchora Referal Hospital Dire Dawa EthiopiaDepartment of Health Behavior and Society, Faculty of Public Health, Institute of Health Jimma University Jimma EthiopiaDepartment of Gynecology and Obstetrics Saint Paul's Hospital Millennium Medical College Addis Ababa EthiopiaSchool of Medicine Goba General Hospital, Madda Walabu University Goba Oromia EthiopiaJimma Medical Center, Department of Gynecology and Obstetrics Jimma University Jimma EthiopiaABSTRACT The twin reversed arterial perfusion (TRAP) sequence is a rare complication associated with monochorionic twins. It is characterized by blood flow from the umbilical artery of the normal (pump) twin to the umbilical artery of the abnormal (acardiac) twin via artery‐to‐artery anastomosis. This condition is associated with 100% mortality in the acardiac twin and a high rate of perinatal morbidity and mortality in the pump twin, primarily due to intrauterine hypoxic injury, heart failure, and prematurity. Following delivery, the surviving pump twin may experience adverse neurodevelopmental outcomes and heart failure, necessitating ongoing follow‐up care. The goal of managing pregnancies complicated by the TRAP sequence is to deliver a healthy, near‐term pump twin through early detection, timely intervention, and continuous follow‐up. However, in low‐resource settings, such as the case presented here, the condition may progress undiagnosed into the third trimester due to a lack of experienced physicians and/or obstetric ultrasound scans. This case report serves as an entry point for a comprehensive review of the literature on management options for the TRAP sequence, specifically focusing on factors to consider when managing patients conservatively in resource‐limited environments or in cases that are referred or diagnosed late.https://doi.org/10.1002/ccr3.70052conservative managementMonochorionic diamnioticpump twintwin arterial perfusion sequenceultrasound scan |
| spellingShingle | Tafese Dejene Abdi Kebede Getahun Fetensa Delayehu Bekele Telila Mesfin Kelil Hussen Twin Reversed Arterial Perfusion Sequence Diagnosed Late in the Third Trimester: A Case Report and Literature Review Clinical Case Reports conservative management Monochorionic diamniotic pump twin twin arterial perfusion sequence ultrasound scan |
| title | Twin Reversed Arterial Perfusion Sequence Diagnosed Late in the Third Trimester: A Case Report and Literature Review |
| title_full | Twin Reversed Arterial Perfusion Sequence Diagnosed Late in the Third Trimester: A Case Report and Literature Review |
| title_fullStr | Twin Reversed Arterial Perfusion Sequence Diagnosed Late in the Third Trimester: A Case Report and Literature Review |
| title_full_unstemmed | Twin Reversed Arterial Perfusion Sequence Diagnosed Late in the Third Trimester: A Case Report and Literature Review |
| title_short | Twin Reversed Arterial Perfusion Sequence Diagnosed Late in the Third Trimester: A Case Report and Literature Review |
| title_sort | twin reversed arterial perfusion sequence diagnosed late in the third trimester a case report and literature review |
| topic | conservative management Monochorionic diamniotic pump twin twin arterial perfusion sequence ultrasound scan |
| url | https://doi.org/10.1002/ccr3.70052 |
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