[Perinatal Management for Monochorionic Twin Reversed Arterial Perfusion Sequence].

Area of Science:

• Perinatology
• Maternal-Fetal Medicine
• Reproductive Medicine

Background:

• Monochorionic twin pregnancies are at risk for complications.
• Twin reversed arterial perfusion (TRAP) sequence is a rare but serious complication.
• Effective perinatal management strategies are essential for optimizing outcomes.

Purpose of the Study:

• To evaluate the perinatal management and outcomes of monochorionic twin pregnancies with TRAP sequence.
• To assess the efficacy of conservative management and interventional procedures.

Main Methods:

• Retrospective study of 13 cases of TRAP sequence in monochorionic pregnancies.
• Analysis of management strategies including conservative care and bipolar cord coagulation.
• Evaluation of perinatal outcomes, including survival of the pump twin.

Main Results:

• TRAP sequence was diagnosed between 11+5 and 31+6 weeks gestation.
• Conservative management resulted in a healthy pump twin in 7 out of 9 cases.
• Bipolar cord coagulation in 2 cases led to the delivery of healthy pump twins.

Conclusions:

• Early antenatal diagnosis of TRAP sequence is critical for timely intervention.
• Conservative management with close monitoring is a viable option for TRAP sequence with small acardiac twins.
• Bipolar cord coagulation is a safe and effective intervention for TRAP sequence when indicated.