Twin Reversed Arterial Perfusion (TRAP) Sequence: A Case Report in Fallujah Maternity and Children Hospital, Fallujah, Iraq
Clinical Medicine Research
Volume 4, Issue 5, September 2015, Pages: 151-153
Received: Jul. 21, 2015;
Accepted: Jul. 31, 2015;
Published: Aug. 10, 2015
Views 6606 Downloads 64
Samira T. Abdulghani Alaani, Central Committee of Birth defects registration and follow up, Fallujah Maternity and Children Hospital, Fallujah, Iraq
Introduction. Twin reversed arterial perfusion (TRAP) sequence is a rare complication of multiple pregnancy caused by defects in early embryogenesis. The pump twin supplies the acardiac recipient twin with blood, and although the pump twin is usually structurally normal, congenital anomalies have sometimes been reported. We report a case of twin reversed arterial perfusion sequence with feet polydactly in the surviving pump twin. This was the 1st case reported in Fallujah city, Iraq. Case report. A 22 years old. gravida 2, para 0. abortion 1, full term lady presented to the delivery room with labour pain with no history of any prenatal care. She gave no history of any familial congenital anomaly and there was no history of consanguinity with her hasbund. She has been referred for cesearian section delivery as an emergency as there was no progress in labour. Ultrasound examination at the delivery room revealed the diagnosis of monozygotic twin, one was normal & the 2nd was diagnosed as (abnormal) with difficulty in visualization of the fetal parts and gender. Conclusion. Twin-Reversed Arterial Perfusion (TRAP) sequence is a rare complication of monozygotic multiple gestation. Accurate antenatal diagnosis is essential to improve the prognosis of this rare entity.
Samira T. Abdulghani Alaani,
Twin Reversed Arterial Perfusion (TRAP) Sequence: A Case Report in Fallujah Maternity and Children Hospital, Fallujah, Iraq, Clinical Medicine Research.
Vol. 4, No. 5,
2015, pp. 151-153.
Healey M: Acardia: predictive risk factors for the co-twin’s survival. Teratology 1994, 50:205-213.
Gembruch U, Viski S, Bagamery K, Berg C, Germer U: Twin reversed arterial perfusion sequence in twin-to-twin transfusion syndrome after the death of the donor co-twin in the second trimester. Ultrasound Obstet Gynecol 2001, 17: 153-156.
Chen CY, Wu YC, Chen CL, Yang ML: Acardiac syndrome coexisting with complex skeletal dysplasia in the co-twin: 3 D sonographic findings. J Clin Ultrasound 2007, 35:387-389.
www.nlm.nih.gov/.../003176. United States National Library of Medicine.
Alaani S, Al-Fallouji M, Busby C, Hamdan M: Pilot Study of Congenital Anomaly Rates at Birth in Fallujah, Iraq, 2010. JIMA: Vol 44, 2012. http://dx.doi.org/10.5915/44-1-10463.
Busby C, Hamdan M, Ariabi E. Cancer, infant mortality and birth sex-ratio in Fallujah, Iraq 2005-2009. Int J Environ Res Public Health. 2010;7:2828-37. http://doi.org/ck8j8z.
Alaani S, Savabieasfahani M, Tafash M et al. Four polygamous families with congenital birth defects from Fallujah Iraq. Int J Environ Res Public Health. 2011; 8: 89-96. http://dx.doi.org/10.3390/ijerph8010089
Alaani S, Tafash M, Busby C, et al. Uranium and other contaminants in hair from the parents of children with congenital anomalies in Fallujah, Iraq. Confl Health. 2011; 5: 15. http://dx.doi.org/10.1186/1752-1505-5-15.
Mohanty C, Mishra OP, Singh CP, et al. Acardiac Anomaly Spectrum. Tetralogy 2000; 62: 356-9.
Shashidhar B. B N kishore kumar. R.Sheela. R.Kalyani. N. Anithae, Prem Sai Reddy. Twin reversed arterial perfusion (TRAP) Sequence: (Acardius Amorphous) a case report and review of literature. Int J Biol Med Res. 2012; 3(1): 1453-1455.
Gembruch U, Viski S, Bagamery K, et al. Twin Reversed Arterial Perfusion Sequence in Twin- to-Twin Transfusion Syndrome after the Death of the Donor Co-Twin in the Second Trimester. Ultrasound Obstet Gynecol 2001; 17: 153-6.
Luiz N. TRAP Syndrome. Indian Pediatr 2003; 40: 683-4.
Weisz B, Peltz R, Chayen B, et al. Tailored Management of Twin Reversed Arterial Perfusion (TRAP) Sequence. Ultrasound Obstet Gynecol 2004; 23: 451-5.
Gibson JY, D'Cruz CA, Patel RB, et al. Acardiac Anomaly: Review of the Subject with Case Report and Emphasis on Practical Sonography. J Clin Ultrasound 1986; 14: 541-5.
Izquierdo L, Smith J, Gilson G, et al. Twin, Acardiac, Acephalus. Fetus 1991; 1: 1-3.
Tan TYT, Sepulveda W. Acardiac twin: A systematic review of minimally invasive treatment modalities Ultrasound Obstet Gynecol. 2003; 22: 409–419.
Ishimatsu J, Nakanami H, Hamada T, Yakushiji M. Color and pulsed Doppler ultrasonography of reversed umbilical blood flow in an acardiactwin. Asia Oceania J Obstet Gynaecol. 1993; 19: 271–275.