What is TRAP sequence method?

Twin reversed arterial perfusion (TRAP) sequence refers to a rare complication unique to monochorionic twin pregnancies in which a severely anomalous twin with an absent or rudimentary heart (“acardiac twin”) is perfused by its co-twin (“pump twin”) via aberrant arterio-arterial anastomoses.

What is trap syndrome?

Twin reversed arterial perfusion (TRAP sequence) is a rare condition of monochorionic twin pregnancies. It arises when the cardiac system of one twin does the work of supplying blood for both twins. The twin supplying the blood is known as the “pump twin” and develops normally in the womb.

Has an Acardiac twin ever survived?

The “acardiac twin” has no chance of survival. Due to the absence of a beating heart, the acardiac does not send blood to any portion of the placenta, and all of its blood supply comes from and goes back to the circulation of the pump twin through unique vascular connections on the surface of the shared placenta.

How common is Acardiac twin?

Twin reversed arterial perfusion (TRAP) used to be known as acardiac twin pregnancy. It is a very rare type of twinning that is only seen in pregnancies with only one placenta, happening in about 1 in every 35,000 identical twin births.

What is twin embolization syndrome?

Twin embolization syndrome (TES) is a complication of monozygotic twinning following in utero demise of the co-twin. Passage of thromboplastic material into the circulation of the surviving twin results in ischemic structural defects of the central nervous system, gastrointestinal tract, and genitourinary system.

What is taps in twins?

TAPS is a rare condition that occurs when there are unequal blood counts between the twins in the womb. Unequal blood counts cause the twins to suffer from an imbalance in red blood cells and hemoglobin. This means one twin is not receiving the appropriate amount of oxygen and nutrients it needs to develop properly.

What causes trap syndrome?

TRAP sequence is caused by the development of one abnormal twin in an identical twin set, or in what is called a monochorionic twin pregnancy. The normal twin then supplies the blood flow for the abnormal twin, which may lead to heart failure and death.

What is a stuck twin?

Definition. A condition whereby a donor twin bleeds into the circulation of a recipient twin. The donor twin become anemic, hypovolemic and looses amniotic fluid. The close apposition of the intertwin membrane fixes the donor fetus in a position thus the moniker of “stuck twin”

Are Mono Di twins hereditary?

Spontaneous monozygotic twins happen by chance. Monozygotic twins do not usually run in families, although there are certainly families with a larger-than-expected number of monozygotic twins, suggesting genetics may sometimes play a role.

What is a parasitic twin?

Parasitic twins occur when a twin embryo begins developing in utero, but the pair does not fully separate, and one embryo maintains dominant development at the expense of its twin.

Is Vanishing twin syndrome common?

According to one study, about 36% of twin pregnancies experience vanishing twin syndrome. It also occurs in around half of multiple pregnancies, or pregnancies where a woman carries more than one baby. Some researchers think the number of women who experience this syndrome may be increasing.

What is twin to twin transfusion syndrome?

Twin-to-twin transfusion syndrome (TTTS) is a rare pregnancy condition affecting identical twins or other multiples. TTTS occurs in pregnancies where twins share one placenta (afterbirth) and a network of blood vessels that supply oxygen and nutrients essential for development in the womb.

How is radiofrequency ablation used to treat trap?

The following procedures have been used to successfully treat TRAP sequence: Radiofrequency ablation (RFA) may be recommended in cases where the gestational age is greater than 16 weeks. This procedure involves the insertion of a small needle into the uterus. The needle contains several sharp prongs that disperse heat energy of radio frequency.

What is twin reversed arterial perfusion ( TRAP sequence )?

What is twin reversed arterial perfusion? Twin reversed arterial perfusion (TRAP sequence) is a rare condition of monochorionic twin pregnancies. It arises when the cardiac system of one twin does the work of supplying blood for both twins. The twin supplying the blood is known as the “pump twin” and develops normally in the womb.

What is the prognosis of a trap sequence?

The prognosis of a TRAP sequence depends on the strain the increased cardiac effort places on the heart of the pump twin. If given enough nutrient support, the body of the acardiac twin can grow at a similar rate as that of the pump twin. When this occurs, the risk of heart failure in the pump twin increases.

What can be done for twins with TRAP sequence?

At The Children’s Hospital of Philadelphia, we offer selective bipolar cord coagulation and radiofrequency ablation (RFA) procedures as treatment options for mothers carrying twins diagnosed with TRAP sequence. The goal of fetal surgery is to interrupt blood supply to the non-viable twin.