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Related Experiment Videos

Twin reverse arterial perfusion sequence.

N A Z Nik Lah1, C A Che Yaakob, M S Othman

  • 1Department of Obstetric & Gynaecology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia. nikzuky@kb.usm.my

Singapore Medical Journal
|November 29, 2007
PubMed
Summary
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Twin reverse arterial perfusion sequence, a rare condition in monochorionic twins, is often fatal. This case highlights successful delivery of a healthy pump twin despite the recipient twin

Area of Science:

  • Perinatology and Maternal-Fetal Medicine
  • Reproductive Biology
  • Developmental Biology

Background:

  • Twin reverse arterial perfusion (TRAP) sequence affects approximately 1% of monochorionic twins.
  • This condition is characterized by a normal 'pump' twin supplying blood to a malformed, acardiac 'recipient' twin.
  • TRAP sequence has high mortality for both twins, necessitating careful management and monitoring.

Observation:

  • A case of acardiac acephalic monochorionic twin diagnosed at 31 weeks gestation is presented.
  • Serial ultrasonography revealed intrauterine growth restriction in the pump twin.
  • No signs of heart failure were observed in the pump twin during monitoring.

Findings:

  • The acardiac acephalic twin, a severe form of TRAP sequence, was diagnosed prenatally.

Related Experiment Videos

  • Despite the presence of the acardiac twin, the pump twin showed signs of growth restriction but maintained hemodynamic stability.
  • Successful delivery of a healthy pump twin was achieved via cesarean section at 34 weeks gestation.

    • Implications:

    • This case demonstrates that even in severe TRAP sequence, conservative management with close monitoring can lead to a favorable outcome for the pump twin.
    • Advances in ultrasonography allow for early diagnosis and monitoring of fetal well-being in complex twin gestations.
    • The findings contribute to the evolving understanding of TRAP sequence management and reinforce the importance of individualized care.