Twin reversed arterial perfusion (TRAP) sequence - Does monoamniocity preclude early intervention?

摘要

A 27-year-old primigravida was referred at 13 weeks' gestation with twin reversed arterial perfusion (TRAP) sequence. The initial scan showed a monoamniotic twin pregnancy including an anencephalic twin without cardiac activity, with retrograde perfusion by an apparently normal pump twin without signs of cardiac compromise. Abdominal circumference and femur length were the same in each twin. The three-vessel cord of the pump twin and the two-vessel cord of the TRAP twin inserted into the placenta with a distance of 15 mm and were twisted together without a knot (Figure 1).