A Case of Trap Sequence (Acardiac Twin) Treatment with Conservatively

Rabia Şerife Beğendik; İsmail Yaman; Begüm Kurt; Nazan Yurtçu

doi:10.7197/cmj.1110498

Case Report

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A Case of Trap Sequence (Acardiac Twin) Treatment with Conservatively

Year 2022, Volume: 44 Issue: 2, 223 - 227, 30.06.2022

Rabia Şerife Beğendik , İsmail Yaman Begüm Kurt , Nazan Yurtçu

https://doi.org/10.7197/cmj.1110498

Abstract

TRAP sequence (twin reversed arterial perfusion) is a complication with a poor prognosis, seen only in monochorionic twin pregnancies, known as acardiac twin formation1. In the very early stages of the formation periods of twin pregnancies, as a result of the single formation of the placenta and the defective formation of the cord vessels of the second baby (acardiac twin), the heart and accordingly the brain development cannot occur in the baby with placenta abnormalities; but other parts of the body can develop in different combinations. Therefore, the second baby can develop from a separate creature to the other baby as a parasite. The normal twin, is known as the pump twin and provides the blood circulation of the acardiac twin. These inter twin anastomoses lead to circulatory confusion, the reverse circulatory morphogenesis interrupted and acardiac twinning occurs2. This case is presented because the patient had a healthy twin who was born due to the onset of preterm labor that was not terminated at the request of the family, and the other twin with acardiac anencephaly. Ablation treatment could not be performed due to the delay in our case, and the pump twin was delivered in a healthy way.

Keywords

Acardiac, monochorionic, pregnancy, pump twin, TRAP, Acardiac, monochorionic, pregnancy, pump twin, TRAP

References

1)Akercan et al. (2009). ‘’Trap (twin reversed arterial perfusion) sekansı’’. Ege Tıp Dergisi, 48 (2): 123-126 http://egetipdergisi.com.tr/tr/download/article-file/350384
2)Etit et al. (2004). ‘’ TRAP (Twin Reversed Arterial Perfusion) Sendromu’’. Perinatoloji Dergisi Cilt:12, Sayı:1 https://www.perinataldergi.com/Files/Archive/tr-TR/Articles/PD-2004012109.pdf
3) Annachiara Vitucci et al. (2019). Division of Obstetrics and Gynecology, ASST Spedali Civili, Department of Clinical and Experimental Sciences, Brescia Üniversitesi, Brescia: İtalya [Elde Edilme Tarihi: 20 Mayıs 2020] https://www.dovepress.com/twin-reversed-arterial-perfusion-sequence-current-treatment-options-peer-reviewed-fulltext-article-IJWH
4) Buyukkaya A, Guven T, Buyukkaya R. Twin Reversed Arterial Perfusion (TRAP) Sequence; Characteristic Gray-Scale and Doppler Ultrasonography Findings. Iranian Journal of Radiology https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4632132/
5) Guven F, Kantarcı F. Çoğul gebeliklerde radyoloji. Türk radyoloji seminerleri Trd Sem 2017; 5: 332-45. https://turkradyolojiseminerleri.org/content/files/sayilar/15/buyuk/332-45.pdf
6) Hecher K, Ville Y, Nicolaides KH. Color Doppler ultrasonography in the identification of communicating vessels in twintwin transfusion syndrome and acardiac twins. J Ultrasound Med 1995; 14:37-40
7)Weisz B, Peltz R, Chayen B, Oren M, Zalel Y, Achiron R, et al. Tailored management of twin reversed arterial perfusion (TRAP) sequence. Ultrasound Obstet Gynecol 2004; 23:451-5. https://www.uptodate.com/contents/diagnosis-and-management-of-twin-reversed-arterial-perfusion-trap-sequence?search=trap%20sequence&source=search_result&selectedTitle=1~8&usage_type=default&display_rank=1
8) Das K. Acardiacus anceps. J Obstet Gynaecol Br Emp 1902; 2: 34 1-35.5.
9) Gabbe ST (2012) Obstetrics: normal and problem pregnancies. (6th edn), Sanders an imprint of Elsevier, USA
10) Wong AE, Sepulveda W. Acardiac anomaly: current issues in prenatal assessment and treatment. Prenat Diagn 2005;25: 796e806.
11) Tan TY, Sepulveda W. Acardiac twin: A systematic review of minimally invasive treatment modalities. Ultrasound Obstet Gynecol 2003; 22:409-19.
12) R. C. Prameela et al. (2014). A Rare Case of Acardiac Twin: A Case Report. Int J Sci Stud 2014;2(8):254-257 https://www.ijss-sn.com/uploads/2/0/1/5/20153321/ijss_nov_cr19.pdf
13) Indian Journal of Radiology Imaging 2009, Case series: TRAP sequence https://www.thieme-connect.com/products/ejournals/abstract/10.4103/0971-3026.45352
14) Enesia Mudenha Ziki, Zvavahera Mike Chirenje, Mugove Gerald Madziyire. A case of twin reversed arterial perfusion (TRAP) sequence managed conservatively. Department of Obstetrics and Gynaecology, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe.
15) Martin J. C. van Gemert et al. (2015). Clinical and Molecular Teratology, Cilt:103, Sayı:7, Sayfa 641-642 [14 Haziran 2015] https://onlinelibrary.wiley.com/doi/10.1002/bdra.23405