TY - JOUR
T1 - TRAP Sequence in Monochorionic/Monoamniotic (MC/MA) Discordant Twins
T2 - Two Cases Treated with Fetoscopic Laser Surgery
AU - Tonni, Gabriele
AU - Grisolia, Gianpaolo
AU - Zampriolo, Paolo
AU - Prefumo, Federico
AU - Fichera, Anna
AU - Bonasoni, Paola
AU - Lefebvre, Mathilde
AU - Khung-Savatovsky, Suonavy
AU - Guimiot, Fabien
AU - Rosenblatt, Jonathan
AU - Júnior, Edward Araujo
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Introduction: Ablation of the acardiac twin umbilical cord in the TRAP protects the normal donor twin. Materials and methods: Two case descriptions, one of interstitial laser photocoagulation and one of laser umbilical cord occlusion (L-UCO) of the acardiac twin in monochorionic monoamniotic pregnancies are reported. Results: L-UCO in two pregnancies with TRAP syndrome in the second trimester resulted in intrauterine fetal death in both cases after 1 month. Case 1 had no detectable cause of fetal death. Case 2 had rupture of the amniotic sac causing anhydramnios and acute chorioamnionitis. A groove on the umbilical cord of the normal twin indicated a cord stricture due to cord entanglement. Conclusion: Our experience confirms that the best timing and optimal treatment of MC/MA twins complicated by TRAP sequence still remains a controversial clinical issue. Cord entanglement may continue be a potential clinical risk factor for adverse perinatal outcome even after ablation therapy.
AB - Introduction: Ablation of the acardiac twin umbilical cord in the TRAP protects the normal donor twin. Materials and methods: Two case descriptions, one of interstitial laser photocoagulation and one of laser umbilical cord occlusion (L-UCO) of the acardiac twin in monochorionic monoamniotic pregnancies are reported. Results: L-UCO in two pregnancies with TRAP syndrome in the second trimester resulted in intrauterine fetal death in both cases after 1 month. Case 1 had no detectable cause of fetal death. Case 2 had rupture of the amniotic sac causing anhydramnios and acute chorioamnionitis. A groove on the umbilical cord of the normal twin indicated a cord stricture due to cord entanglement. Conclusion: Our experience confirms that the best timing and optimal treatment of MC/MA twins complicated by TRAP sequence still remains a controversial clinical issue. Cord entanglement may continue be a potential clinical risk factor for adverse perinatal outcome even after ablation therapy.
KW - Cristal and Realistic Vue
KW - fetal pathology
KW - fetoscopic laser photocoagulation
KW - monochorionic/monoamiotic twins
KW - TRAP sequence
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U2 - 10.1080/15513815.2018.1526240
DO - 10.1080/15513815.2018.1526240
M3 - Article
AN - SCOPUS:85060028418
JO - Fetal and Pediatric Pathology
JF - Fetal and Pediatric Pathology
SN - 1551-3815
ER -