Twin reversed arterial perfusion syndrome

Area of Science:

• Perinatology
• Maternal-Fetal Medicine
• Reproductive Medicine

Background:

• Twin reversed arterial perfusion (TRAP) syndrome is a rare, severe complication specific to monochorionic twin pregnancies.
• Outcomes are frequently fatal, impacting both the acardiac twin and potentially the pump twin (50-75%).
• Prenatal diagnosis is suspected when cardiac activity is absent in one twin of a multiple pregnancy.

Purpose of the Study:

• To review and discuss the pathogenic mechanisms of TRAP syndrome.
• To outline the clinicopathologic features and diagnostic approaches, particularly echographic methods.
• To explore management strategies for high-risk pregnancies complicated by TRAP syndrome.

Main Methods:

• Literature research was conducted to gather information on TRAP syndrome.
• Pathogenic mechanisms, anatomical findings, and diagnostic criteria were analyzed.
• Management options for affected pregnancies were reviewed based on existing studies.

Main Results:

• TRAP syndrome arises from abnormal vascular anastomoses in monochorionic twins.
• Echographic findings are key to prenatal diagnosis, especially the absence of cardiac activity in the acardiac twin.
• Management strategies aim to improve outcomes for the pump twin.

Conclusions:

• TRAP syndrome necessitates prompt prenatal diagnosis and intervention.
• Understanding the pathophysiology aids in diagnosis and management.
• Effective management can improve survival rates for the pump twin in these high-risk pregnancies.