Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-21T12:20:52.959Z Has data issue: false hasContentIssue false
  • English
  • Français

Twin Reversed Arterial Perfusion Syndrome

Published online by Cambridge University Press:  01 August 2014

W. Malinowski  and
W. Wierzba
W. Malinowski*
Affiliation:
Department of Obstetrics and Gynaecology, Kutno Hospital, Poland
W. Wierzba
Affiliation:
Department of Obstetrics and Gynaecology, Plock Hospital, Poland
*
Department of Obstetrics and Gynecology, Kutno Hospital, 42 Kościuszki Street, 99-300 Kutno, Poland.

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Twin reversed arterial perfusion (TRAP) syndrome is a rare but severe complication of monozygotic monochorionic twin pregnancies. The outcome is invariably fatal for the abnormal twins and for 50-75% of the normal co-twins. The prenatal diagnosis of the TRAP always has to be presumed in a multiple pregnancy within which a twin pair grows whenever cardiac activity can not be proved echographically. We present discuss – based upon literature research – pathogenic mechanisms, pathologic-anatomic, echographic diagnosis and management of these high-risk pregnancies.

Keywords

Twin reversed arterial perfusion (TRAP) syndromeUltrasound diagnosis
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 47 , Issue 2 , April 1998 , pp. 75 - 87
Copyright
Copyright © The International Society for Twin Studies 1998

References

REFERENCES

1.Amatuzio, JCGorlin, R (1981): Conjoined acardiac monsters. Arch Pathol Lab Med 105: 253–5.Google ScholarPubMed
2.Ash, K, Harman, CRGritter, H (1990): TRAP sequence – successful outcome with indomethacin tretment. Obstet Gynecol 76: 960–2.Google Scholar
3.Auerback, P, Wiglesworth, FW (1978): Congenital absence of the heart: observation of a human funiculo pagus twinning with insertio funiculi furcata, fusion, forking and interpositio velamentos. Tetralogy 17: 143–50.Google Scholar
4.Baldwin, VJ (1991): Pathology of Multiple Pregnancy. Textbook of Fetal and Perinatal Pathology. Scientific Publications, Boston221.Google Scholar
5.Baldwin, VJ (1994): Pathology of Multiple Pregnancy. New York, Springer-Verlag.Google Scholar
6.Benirschke, K, Harper, V (1977): The arcardiac anomaly. Tetralogy 15: 311–6.Google Scholar
7.Benson, CBBieber, FRGenest, DRDoubilet, PM (1989): Doppler demonstration of reversed umbilical blood flow in an acardiac twin. J Clin Ultrasound 17: 291–5.Google Scholar
8.Bieber, FRNance, WEMorton, CCet al. (1981): Genetic studies of an acardiac monster: evidence of polar body twinning in man. Science 213: 775–7.CrossRefGoogle ScholarPubMed
9.Billah, KLShah, K, Odwin, C (1981): Ultrasound diagnosis and management of acardius anencephalic twin pregnancy. Med Ultrasound 8: 108–9.Google Scholar
10.Deacon, JSMachin, GAMartin, Jet al (1980): Investigation of acephalus. Am J Med Genet 5: 85–9.Google Scholar
11.Fries, MHGoldberg, JDGolbus, MS (1992): Treatment of acardiac-acephalus twin gestation by hysterotomy and selective delivery. Obstet Gynecol 79: 601–4.Google Scholar
12.Gewolb, IHFreedman, RMKleinman, CSHobbins, JC (1983): Prenatal diagnosis of a human pseudo-acardiac anomaly. Obstet Gynecol 61: 657–62.Google Scholar
13.Gillim, DLHendrics, CH (1953): Holocardius: Review of the literature and case report. Obstet Gynecol 2: 647–53.Google Scholar
14.Ginsberg, NAApplebaum, M, Rabin, SAet al (1992): Term birth after midtrimester hysterotomy and selective delivery of an acardiac twin. Am J Obstet Gynecol 167: 33–7.Google Scholar
15.Hamada, H, Okane, M, Koresawa, Met al (1992): Fetal therapy in utero by blockage of the umbilical blood flow of acardiac monster in twin pregnancy (English abstract). Nippon-Sanaka-Fujinka-Gakkai-Zasshi 41: 1803–9.Google Scholar
16.Harkavy, KLScanion, JW (1978): Hydrops fetalis in a parabiotic acardiac twin. Am J Dis Child 132: 638–9.Google Scholar
17.Heifetz, SA (1984): Single umbilical artery. A statistical analysis of 237 autopsy cases and review of the literature. Prespect Pediatr Pathol 8: 345–78Google Scholar
18.Imai, A, Hirose, R, Kawabata, I, Tamaya, T (1991): Acardiac acephalic monster extremely larger than the co-twin. A case report. Gynecol Obstet Invest 32: 62–4.Google Scholar
19.James, WH (1977): A note on the epidemiology of acardiac monsters. Tetralogy 16: 211–6.Google Scholar
20.Kaplan, C, Benirschke, K (1979): The acardiac anomaly. New case reports and current status. Acta Gene Med Gemellol 28: 51–9.Google Scholar
21.Keith, L (1974): Holocardius. J Reprod Med 12: 82–5.Google Scholar
22.Ketchum, J, Motyloff, L (1957): Chorangiopagus parasiticus (Schwalbe). Report of a case of acardius acephalus and of a case of fetus amorphus. Am J Obstet Gynecol 73: 1349–54.Google Scholar
23.Kirkinen, P, Herva, R, Rasanen, Jet al (1989): Documentation of paradoxical umbilical blood supply of an acardiac twin in the antepartum state. J Perinat Med 17: 63–5.Google ScholarPubMed
24.Kyriazis, A, Arean, VMShanklin, DR (1974): Placental radiographic analysis of parasitic acardiac fetus; partially aommon umbilical circulation. J Reprod Med 12: 74–81.Google ScholarPubMed
25.Leroy, F (1976): Major fetal hazards in multiple pregnancy. Acta Genet Med Gemellol 25: 299–306.Google Scholar
26.Lindhai, SABaldwin, VJWakeford, J, Wittmann, BK (1984): Early diagnosis of an acardiac acephalus twin by ultrasound. Med Ultrasound 8: 105–7.Google Scholar
27.Malinowski, W, Lipiec, W (1994): Ultrasound diagnosis of an acardiac twin. Ultrason Pol 4: 80–4.Google Scholar
28.Moore, CABuehler, BAMcManus, BMet al (1987): Brief clinical report: acephalusacardia in twins with aneuploidy. Am J Med Genet Suppl 3: 139–43.Google Scholar
29.Moore, TRGale, S, Benirschke, K (1990): Perinatal outcome of forty-nine pregnancies complicated acardiac twinning. Am J Obstet Gynecol 163: 907–12.Google Scholar
30.Nance, WA (1981): Malformations unique to the twinning process. Prog Clin Biol Res 69: 123–33.Google Scholar
31.Napolitani, FDSchreiber, I (1960): The acardiac monster. A review of the world literature and presentation of 2 cases. Am J Obstet Gynecol 80: 582–89.Google Scholar
32.Nerlich, A, Wisser, J, Draeger, Aet al (1990): Human acardiac anomaly: a report of three cases. Eur J Obstet Gynecol Reprod Biol 38: 79–85.Google Scholar
33.Piatt, LBDe Vore, GRBieniarz, Aet al (1983): Antenatal diagnosis of acephalus acardia: A proposed management scheme. Am J Obstet Gynecol 146: 857–9.Google Scholar
34.Porreco, RPBarton, SMHaverkamp, AD (1991): Occlusion of umbilical artery in acardiac acephalus twin. Lancet 1: 326–7.Google Scholar
35.Price, B (1950): Primary biases in twin studies – a review of perinatal and natal difference producing factors in monozygotic pairs. Am J Hum Genet 2: 293–352.Google Scholar
36.Robie, GFPayne, GGMorgan, MA (1989): Selective delivery of an acardiac acephalic twin. N Engl J Med 320: 512–3.Google Scholar
37.Sato, T, Kaneko, K, Konuma, Set al (1984): Acardiac anomalies: review of 88 cases in Japan. Asia-Oceana J Obstet Gynecol 10: 45–52.CrossRefGoogle ScholarPubMed
38.Schinzel, AASmith, DWMiller, JR (1979): Monozygotic twinning and structural defects. J Pediatr 95: 921–30.Google Scholar
39.Scott, JMFerguson-Smith, MA (1973): Heterokaryotypic monozygotic twins and the acardiac monster. J Obstet Gynaecol Br Cwlth 80: 52–9.Google Scholar
40.Severn, CBHolyoke, EA (1973): Human acardiac anomalies. Am J Obstet Gynecol 116: 358–65.Google Scholar
41.Sherer, DMArmstrong, B, Shah, YGet al (1989): Prenatal sonographic diagnosis. Doppler velocimetric umbilical cord studies and subsequent management of an acardiac twin pregnancy. Obstet Gynecol 74: 472–5.Google Scholar
42.Simonds, JPGowen, GA (1925): Fetus amorphus (report of a case). Surg Gynecol Obstet 41: 171–9.Google Scholar
43.Simpson, PCTrudinger, BJWalker, A, Baird, PJ (1983): The intrauterine treatment of fetal cardiac failure in a twin pregnancy with an acardiac acephalic monster. Am J Obstet Gynecol 147: 842–4.Google Scholar
44.Stephens, TD (1984): Muscle abnormalities associated with the twin reverse- arterial-perfusion (TRAP) sequence (acardia). Tetralogy 30:311–8.Google Scholar
45.Stiller, RJRomero, R, Pace, S, Hobbins, JC (1989): Prenatal identification of twin reversed arterial perfusion syndrome in the first trimester. Am J Obstet Gynecol 160: 1194–6.Google Scholar
46.Van Allen, MI (1981): Fetal vascular disruptions: mechanisms and some resulting birth defects. Pediatr Ann 10: 219–33.Google Scholar
47.Van Allen, MISmith, DWShepard, TH (1983): Twin reversed arterial perfusion (TRAP) sequence: a study of 14 twin pregnancies with acardius. Sem Perinat 7: 285–93.Google Scholar
48.Warkany, J (1971): Congenital Malformations. Chicago: Year Book Medical Publishers; 474.Google Scholar
49.Wolf, HKMac Donald, J, Bradford, WBLahman, JT (1991): Acardius anceps with evidence of intrauterine vascular occlusion: report of a case and discussion of pathogenesis. Pediatr Pathol 11: 143–52.Google Scholar