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Related Experiment Video

Updated: Dec 24, 2025

Model Surgical Training: Skills Acquisition in Fetoscopic Laser Photocoagulation of Monochorionic Diamniotic Twin Placenta Using Realistic Simulators
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Intrafetal laser for midtrimester TRAP sequence-experience from a single center.

Suresh Seshadri1, Roopa R Shinde1, Uma Ram2

  • 1Fetal Medicine Department, Mediscan Systems, Chennai, India.

Prenatal Diagnosis
|April 14, 2020
PubMed
Summary

Intrafetal laser therapy effectively treats Twin Reversed Arterial Perfusion (TRAP) sequence in monochorionic pregnancies. This minimally invasive procedure offers a high live birth rate, making it a preferred option for managing acardiac twins.

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Area of Science:

  • Maternal-Fetal Medicine
  • Perinatology
  • Interventional Obstetrics

Background:

  • Twin Reversed Arterial Perfusion (TRAP) sequence is a rare complication of monochorionic pregnancies.
  • It involves an abnormal vascular connection where one twin (acardiac) is perfused by the other (pump twin).
  • Untreated TRAP sequence has a high mortality rate for the pump twin.

Purpose of the Study:

  • To report the experience and evaluate outcomes of intrafetal laser therapy for TRAP sequence.
  • To assess the efficacy and safety of this intervention in monochorionic pregnancies.

Main Methods:

  • Retrospective review of pregnancies with TRAP sequence treated with intrafetal laser therapy between January 2011 and December 2015.
  • Analysis of scan database for case identification and review of treatment records.

Main Results:

  • 27 cases (22 twins, 5 triplets) underwent intrafetal laser therapy.
  • In twin gestations, median gestational age at intervention was 22.5 weeks.
  • Live birth rate was 77% (17/22), with a pump survival rate of 73% (16/22).

Conclusions:

  • Intrafetal laser therapy is a simple and effective treatment for TRAP sequence.
  • It is considered the treatment of choice for interrupting vascular supply to the acardiac twin.