Cic edizioni internazionali
Journal of Prenatal Medicine

Conservative management in a case of uncomplicated trap sequence: a case report and brief literature review

Case report, 29 - 34
doi: 10.11138/jpm/2015.9.3.029
Tag this article
Enhanced HTML Full text PDF
Introduction: twin reversed arterial perfusion (TRAP) sequence is a rare anomaly that occurs in monochorionic twins with overall mortality rate ranging from 50% to 70% in the normal fetus, above all for congestive cardiac failure.
Case report: a 31-year-old Caucasian gravida was referred to our fetomaternal medicine unit in the 25 gestational age. Ultrasound examination revealed a monochorionic, biamniotic twin pregnancy with a donor fetus showing normal morphology and growth corresponding to gestational age.
The recipient twin appeared grossly abnormal with no head, upper limbs, heart, or thoracic structures and massive, diffuse, soft tissue edema.
Fetal Doppler and fetal echocardiography revealed normal parameters. The patient refused any treatment and was monitored with weekly ultrasonography and Doppler ultrasound examination.
She underwent cesarean section due to premature labor/rupture of membranes secondary to a mild polyhydramnios, at 36 weeks gestational age and delivered an apparent normal female live baby weighing 2550 gr, and another female acardius acephalus twin, birth weight 1300 gr. This baby had rudimental edematous lower limbs, pelvic bone, lower sacral vertebrae, and absence of thorax and cephalic structures.
Conclusion: although the literature suggest that early intrafetal laser treatment of TRAP sequence is advantageous, our case shows that pregnancies referred late would still require a tailored approach after a risk-benefit assessment.

Vol. 10 (No. 3-4) 2016 July - December

  1. Fetal-MRI prenatal diagnosis of severe bilateral lung hypoplasia: alveolar capillary dysplasia case report
    Zirpoli S., Munari A.M., Rustico M., Bulfamante G., Lista G., Spaccini L., Cesaretti C.
    doi: 10.11138/jpm/2016.10.3.015
  2. A case of polimalformed fetus with a microdeletion of CTNNA3 gene
    Cancemi D., Urciuoli M., Morelli F., Lonardo M.C., Spampanato C., Ventruto M., Ventruto V., Sica C.
    doi: 10.11138/jpm/2016.10.3.020
  3. Predictive value of procalcitonin or c-reactive protein for subclinical intrauterine infection in patients with premature rupture of membranes (PROM)
    Li K., Yu H., Wang X., Liu X.
    doi: 10.11138/jpm/2016.10.3.023
Last Viewed articles: la lista degli ultimi x visitati.
  1. Conservative management in a case of uncomplicated trap sequence: a case report and brief literature review
    Pepe F., Teodoro M.C., Luca C., Privitera F.
    doi: 10.11138/jpm/2015.9.3.029