Twin reversed arterial perfusion (TRAP) sequence

Case contributed by Alexandra Stanislavsky
Diagnosis certain

Presentation

Pregnancy review at 17 weeks gestation.

Patient Data

Age: 25 years
Gender: Female

"Pump" twin - normal biometry and morphology. There is a small pericardial effusion but no evidence of cardiomegaly or hydrops.

Acardiac twin - distorted and underdeveloped anatomy, severe hydrops with cystic hygromas. A single umbilical artery with flow towards the fetus.

Single posterior placenta. There is a large artery to artery anastomosis on the superficial aspect of the placenta between the pump and acardiac cord insertions (see the second stack).

The cervix is closed.

Case Discussion

Typical findings in a twin reversed arterial perfusion (TRAP) sequence. 

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