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Accurate and Simple Evaluation of Vascular Anastomoses in Monochorionic Placenta using Colored Dye

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Published on: September 5, 2011

Twin Reversed Arterial Perfusion (TRAP) Sequence Phenotypes: A Comprehensive Visual Analysis.

Gabriele Tonni¹, Gianpaolo Grisolia², Giosuè Giordano Incognito³

¹Department of Obstetrics and Neonatology, and Researcher, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), ASL Reggio Emilia, Reggio Emilia, Italy.

Journal of Clinical Ultrasound : JCU

|May 15, 2025

Summary

Twin reversed arterial perfusion (TRAP) sequence is a rare complication of monochorionic twins. Early ultrasound diagnosis of this condition is crucial for effective antenatal management and treatment.

Keywords:

TRAP sequence acardiac twin monochorionic twins prenatal diagnosis twin pregnancy twin reversed arterial perfusion sequence

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Area of Science:

Perinatology
Maternal-Fetal Medicine
Medical Imaging

Background:

Twin reversed arterial perfusion (TRAP) sequence is a severe complication in monochorionic twin pregnancies.
It involves a nonviable acardiac twin perfused by a structurally normal pump twin via placental anastomoses.

Purpose of the Study:

To illustrate sonographic and Doppler findings of TRAP sequence.
To emphasize key prenatal diagnostic features for clinicians and sonographers.

Main Methods:

Pictorial essay format presenting characteristic sonographic and Doppler findings.
Illustrative cases showcasing diverse TRAP sequence phenotypes.

Main Results:

TRAP sequence diagnosis relies on identifying an acardiac twin with absent cardiac activity and reversed umbilical artery flow.
Associated anomalies include acardia, acrania, and underdeveloped upper body in the acardiac twin.

Conclusions:

Early and accurate diagnosis of TRAP sequence through ultrasound is vital.
Close monitoring and timely antenatal treatment selection are essential for managing TRAP sequence.