Management of twin reversed arterial perfusion sequence: eight cases over 13 years.
Ann Saudi Med
; 43(4): 199-203, 2023.
Article
en En
| MEDLINE
| ID: mdl-37554025
ABSTRACT
BACKGROUND:
Twin reversed arterial perfusion (TRAP) sequence is a rare condition that affects primarily monozygotic monochorionic twin pregnancies in which a normal twin acts as a pump (donor) for an acardiac recipient (perfuse) twin.OBJECTIVE:
We report our experience over the last 13 years at a tertiary health care center.DESIGN:
Descriptive, retrospective case seriesSETTING:
Tertiary health care center PATIENTS ANDMETHODS:
All TRAP cases managed between the years 2009 and 2022 at our Fetal Diagnosis and Therapy Center were included. Data recorded included demographic and clinical information which was used to generate descriptive data. Patients were managed by a multidisciplinary team with variable interventions. MAIN OUTCOMEMEASURE:
Survival of normal twin SAMPLE SIZE EightRESULTS:
Eight pregnant women with TRAP syndrome were managed at our center during that period. One was monozygotic monochorionic and the others were monochorionic diamniotic. Median maternal age at presentation was 27 years and median gestational age at diagnosis was 23 weeks. All were diagnosed with ultrasound (US) imaging. Three were managed with bipolar ligation of the cord of the acardiac twin under general anesthesia, one US-guided (single port) and 2 fetoscopic (2 ports) with a median operative time of 39 minutes. The last five cases were managed with US-guided radiofrequency ablation (RFA) under local anesthesia, one needed 2 sessions, 1 week apart. The median duration of the RFA procedure was 23 minutes. There were no complications and all had viable normal babies born at a median of 32 weeks of gestation (6 C-section, 2 spontaneous membrane rupture).CONCLUSIONS:
Acardiac twin cord ligation and RFA are feasible and safe options with excellent outcome for TRAP syndrome. RFA may be preferable owing to its less invasiveness under local anesthesia.LIMITATIONS:
None, given the rarity of the disease and the study design. CONFLICT OF INTEREST None.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Transfusión Feto-Fetal
/
Cardiopatías Congénitas
Límite:
Female
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Humans
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Infant
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Pregnancy
Idioma:
En
Revista:
Ann Saudi Med
Asunto de la revista:
MEDICINA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Arabia Saudita