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Related Experiment Video

Updated: Jul 15, 2026

Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas

Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas

Published on: September 5, 2011

TRAP sequence in an acardiac twin.

Athita Chanthasenanont¹, Densak Pongrojpaw

¹Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand. athitaka@gmail.com

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet

|May 10, 2007

Summary

Expectant management of twin reversed-arterial perfusion (TRAP) sequence is a viable option. Close surveillance can lead to favorable outcomes for the pump twin, challenging previous mortality rates.

Area of Science:

Perinatology
Maternal-Fetal Medicine
Reproductive Genetics

Background:

Twin reversed-arterial perfusion (TRAP) sequence is a rare complication of monozygotic twinning.
It involves an abnormal vascular connection where one twin (acardius) develops without a heart, relying on the other twin (pump twin) for circulation.

Observation:

A case of TRAP sequence diagnosed sonographically at 20 weeks gestation.
The acardiac twin was significantly smaller and lacked defined extremities.
Parents opted for expectant management with serial sonographic and Doppler monitoring.

Findings:

The pump twin developed signs of fetal congestive heart failure (CHF) at 34 weeks.
Delivery via cesarean section resulted in a healthy infant.

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The acardius was approximately two-thirds the size of the delivered infant.

Implications:

Expectant management with close antepartum surveillance is a reasonable approach for TRAP sequence.
Antenatal diagnosis and monitoring may significantly reduce the previously reported neonatal mortality for the pump twin.