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Related Experiment Video

Updated: Apr 15, 2026

Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas
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Twin reversed arterial perfusion sequence: a rare entity.

Sachin Khanduri1, Saakshi Chhabra1, Anshul Raja1

  • 1Department of Radiodiagnosis, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India.

Journal of Clinical Imaging Science
|April 11, 2015
PubMed
Summary

Twin reversed arterial perfusion (TRAP) sequence, a rare pregnancy complication, involves one twin perfusing a malformed co-twin. Early diagnosis via advanced imaging is crucial for improving pump twin outcomes.

Keywords:
Magnetic resonance imagingmonochorionic twin pregnancypulsed Dopplertwin reversed arterial perfusionultrasonography

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Area of Science:

  • Perinatology
  • Maternal-Fetal Medicine
  • Medical Imaging

Background:

  • Twin reversed arterial perfusion (TRAP) sequence is a rare complication of monochorionic twin pregnancies.
  • It involves reversed blood flow from a structurally normal 'pump' twin to a malformed, non-viable co-twin.

Observation:

  • A case report details a primigravida diagnosed at 31 weeks gestation.
  • Ultrasound and MRI confirmed a monochorionic pregnancy with a viable twin and an acardius acephalus twin.
  • The pump twin was monitored weekly using ultrasonography, echocardiography, and Doppler studies.

Findings:

  • The patient delivered a healthy baby and an acardius acephalus fetus at term.
  • Plain X-ray confirmed the absence of cephalic structures in the acardius fetus.

Implications:

  • Perinatal mortality for the pump twin ranges from 35% to 55%.
  • Early diagnosis using advanced imaging techniques is essential for timely intervention.
  • Improved diagnostic strategies can enhance the prognosis for the pump twin in TRAP sequence.