Individualized intervention and growth dynamics assessment in TRAP sequence with conjoined twins based on radiofrequency ablation
Abstract Background Twin reversed arterial perfusion (TRAP) sequence with conjoined twins (CTs) represents an exceedingly rare and critical complication in monochorionic monoamniotic (MCMA) twin pregnancies. High mortality rates are associated with this condition, making early diagnosis and manageme...
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| Language: | English |
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BMC
2025-05-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-025-07658-1 |
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| author | Hua Lai Huiting Zhu Jinliang Zhang Juhua Xiao Mengjiao Liu Danping Liu Zengming Li Xin Zhou |
| author_facet | Hua Lai Huiting Zhu Jinliang Zhang Juhua Xiao Mengjiao Liu Danping Liu Zengming Li Xin Zhou |
| author_sort | Hua Lai |
| collection | DOAJ |
| description | Abstract Background Twin reversed arterial perfusion (TRAP) sequence with conjoined twins (CTs) represents an exceedingly rare and critical complication in monochorionic monoamniotic (MCMA) twin pregnancies. High mortality rates are associated with this condition, making early diagnosis and management crucial for improving survival outcomes, particularly for the pump twin. Case presentation This case report focuses on a unique instance of TRAP-associated CTs, diagnosed at 13 weeks and 1 day of gestation. Management involved detailed ultrasonography and radiofrequency ablation (RFA) at 18 weeks and 5 days to interrupt the blood supply to the non-viable acardiac twin. This intervention allowed the pump twin to continue normal development, culminating in a cesarean delivery at 35 weeks and 1 day. The newborn showed a healthy postnatal outcome with no significant neurodevelopmental deficits noted at follow-up. Conclusions Early identification and tailored intervention are essential in cases of TRAP sequence associated with conjoined twins. This case exemplifies the potential of integrated multidisciplinary approaches and timely use of RFA, which significantly enhance the prognosis for the viable twin. These strategies are vital for managing complex MCMA pregnancies and can inform future clinical practices. Graphical abstract |
| format | Article |
| id | doaj-art-79c4a4fd36ab4eec9fe37caa46d98aca |
| institution | DOAJ |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-79c4a4fd36ab4eec9fe37caa46d98aca2025-08-20T03:10:31ZengBMCBMC Pregnancy and Childbirth1471-23932025-05-012511910.1186/s12884-025-07658-1Individualized intervention and growth dynamics assessment in TRAP sequence with conjoined twins based on radiofrequency ablationHua Lai0Huiting Zhu1Jinliang Zhang2Juhua Xiao3Mengjiao Liu4Danping Liu5Zengming Li6Xin Zhou7Department of Obstetrics, Jiangxi Maternal and Child Health HospitalDepartment of Obstetrics, Jiangxi Maternal and Child Health HospitalDepartment of Obstetrics, Jiangxi Maternal and Child Health HospitalDepartment of Ultrasound, Jiangxi Maternal and Child Health HospitalJiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang UniversityDepartment of Genetics, Jiangxi Maternal and Child Health HospitalJiangxi Key Laboratory of Reproductive HealthDepartment of Ultrasound, Jiangxi Maternal and Child Health HospitalAbstract Background Twin reversed arterial perfusion (TRAP) sequence with conjoined twins (CTs) represents an exceedingly rare and critical complication in monochorionic monoamniotic (MCMA) twin pregnancies. High mortality rates are associated with this condition, making early diagnosis and management crucial for improving survival outcomes, particularly for the pump twin. Case presentation This case report focuses on a unique instance of TRAP-associated CTs, diagnosed at 13 weeks and 1 day of gestation. Management involved detailed ultrasonography and radiofrequency ablation (RFA) at 18 weeks and 5 days to interrupt the blood supply to the non-viable acardiac twin. This intervention allowed the pump twin to continue normal development, culminating in a cesarean delivery at 35 weeks and 1 day. The newborn showed a healthy postnatal outcome with no significant neurodevelopmental deficits noted at follow-up. Conclusions Early identification and tailored intervention are essential in cases of TRAP sequence associated with conjoined twins. This case exemplifies the potential of integrated multidisciplinary approaches and timely use of RFA, which significantly enhance the prognosis for the viable twin. These strategies are vital for managing complex MCMA pregnancies and can inform future clinical practices. Graphical abstracthttps://doi.org/10.1186/s12884-025-07658-1Twin reversed arterial perfusionConjoined twinsMonochorionic monoamnioticRadiofrequency ablationFetal growth curvePerinatal management |
| spellingShingle | Hua Lai Huiting Zhu Jinliang Zhang Juhua Xiao Mengjiao Liu Danping Liu Zengming Li Xin Zhou Individualized intervention and growth dynamics assessment in TRAP sequence with conjoined twins based on radiofrequency ablation BMC Pregnancy and Childbirth Twin reversed arterial perfusion Conjoined twins Monochorionic monoamniotic Radiofrequency ablation Fetal growth curve Perinatal management |
| title | Individualized intervention and growth dynamics assessment in TRAP sequence with conjoined twins based on radiofrequency ablation |
| title_full | Individualized intervention and growth dynamics assessment in TRAP sequence with conjoined twins based on radiofrequency ablation |
| title_fullStr | Individualized intervention and growth dynamics assessment in TRAP sequence with conjoined twins based on radiofrequency ablation |
| title_full_unstemmed | Individualized intervention and growth dynamics assessment in TRAP sequence with conjoined twins based on radiofrequency ablation |
| title_short | Individualized intervention and growth dynamics assessment in TRAP sequence with conjoined twins based on radiofrequency ablation |
| title_sort | individualized intervention and growth dynamics assessment in trap sequence with conjoined twins based on radiofrequency ablation |
| topic | Twin reversed arterial perfusion Conjoined twins Monochorionic monoamniotic Radiofrequency ablation Fetal growth curve Perinatal management |
| url | https://doi.org/10.1186/s12884-025-07658-1 |
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