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Related Experiment Video

Updated: Jan 20, 2026

Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
10:52

Closure of a Patent Foramen Ovale PFO: An Intervention Sequence

Published on: December 23, 2022

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First-trimester intervention in twin reversed arterial perfusion sequence.

M Tavares de Sousa1, P Glosemeyer1, A Diemert1

  • 1Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
|September 6, 2019
PubMed
Summary

Interstitial laser therapy effectively treats twin reversed arterial perfusion (TRAP) sequence in monochorionic twins during the first trimester, achieving a 92% live birth rate with minimal complications.

Keywords:
TRAPfirst-trimester interventionmonochorionic twinstwin reversed arterial perfusion

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Area of Science:

  • Maternal-fetal medicine
  • Perinatology
  • High-risk pregnancy management

Background:

  • Twin reversed arterial perfusion (TRAP) sequence is a rare complication of monochorionic twinning.
  • It necessitates timely intervention to improve perinatal outcomes.
  • Interstitial laser therapy offers a minimally invasive treatment option.

Purpose of the Study:

  • To evaluate the efficacy and safety of first-trimester interstitial laser therapy for TRAP sequence.
  • To determine perinatal survival and morbidity rates following this intervention.

Main Methods:

  • Retrospective cohort study of 12 monochorionic twin pregnancies with TRAP sequence.
  • Interstitial laser therapy of the acardiac twin's umbilical artery performed at ≤14+3 weeks gestation.
  • Ultrasound guidance with a 400-nm Nd:YAG laser fiber.

Main Results:

  • Successful interruption of acardiac twin perfusion in all cases with one treatment.
  • No procedure-related complications occurred.
  • A live birth rate of 91.7% was achieved, with no neonatal mortality or serious morbidity.

Conclusions:

  • First-trimester interstitial laser therapy is a safe and effective treatment for TRAP sequence.
  • The procedure demonstrates a high live birth rate and favorable neonatal outcomes.
  • Further research, including randomized controlled trials, is warranted to compare early versus late interventions.