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First-trimester findings associated with twin reversed arterial perfusion sequence
Masato Kamitomo1, Satoshi Kouno, Kyoko Ibuka
1Department of Obstetrics and Gynecology, Kagoshima City Hospital, Kagoshima, Japan. kamitomo@ml.kch.kagoshima.kagoshima.jp
Fetal Diagnosis and Therapy
|February 7, 2004
Summary
Early first-trimester ultrasound identified a discordant monochorionic twin pregnancy, suggesting it may be an early sign of twin-reversed arterial perfusion (TRAP) sequence.
Area of Science:
- Perinatology
- Fetal Medicine
- Reproductive Biology
Background:
- Twin-reversed arterial perfusion (TRAP) sequence pathogenesis is linked to discordant development and vascular anastomoses in early gestation.
- However, early first-trimester findings for TRAP sequence have not been previously documented.
Observation:
- A monochorionic twin gestation presented with discordancy at 11 weeks.
- The smaller twin exhibited cystic masses, edema, and pericardial effusion, indicative of cardiac failure.
- The smaller twin later developed acardia anceps/hemicardia despite initial fetal demise diagnosis.
Findings:
- First-trimester discordancy in monochorionic twins is a potential early sign of TRAP sequence.
- The observed case aligns with current hypotheses on acardiac anomaly pathogenesis.
Implications:
- This case provides novel insights into the early presentation of TRAP sequence.
- Understanding early manifestations can aid in timely diagnosis and management of TRAP sequence.