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Published on: September 5, 2011
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Twin reversed arterial perfusion (TRAP) sequence and placenta accreta
Maureen Cohen Bacry1, Marion Le Hegarat1, Marc Althuser1
1Department of Gynecology and Obstetrics, Hôpital Couple Enfant, Université Grenoble Alpes, La Tronche, France.
Summary
Twin reversed arterial perfusion (TRAP) sequence is a rare complication of identical twin pregnancies. This case highlights a severe hemorrhage during delivery due to placenta accreta, necessitating a hysterectomy.
Area of Science:
- Perinatology
- Maternal-Fetal Medicine
- Obstetrics
Background:
- Twin reversed arterial perfusion (TRAP) sequence is a rare and severe complication in monozygotic pregnancies.
- Abnormal placentation, such as placenta accreta, is more common in multiple gestations.
Observation:
- A 35-year-old woman with a diagnosed TRAP sequence in her second pregnancy experienced severe hemorrhage during delivery.
- The hemorrhage was attributed to an undiagnosed placenta accreta, leading to emergency hysterectomy.
Findings:
- The case suggests a potential link between the pathophysiology of TRAP sequence and the occurrence of placenta accreta.
- This association may arise from the altered hemodynamic and vascular demands in TRAP pregnancies.
Implications:
- Clinicians should consider the possibility of co-existing abnormal placentation in cases of TRAP sequence.
- Awareness of this association is crucial for improved management and outcomes in high-risk multiple pregnancies.
