Abstract
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.
| Original language | English |
|---|---|
| Journal | Fetal and Pediatric Pathology |
| DOIs | |
| Publication status | Accepted/In press - Jan 1 2019 |
| Externally published | Yes |
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Keywords
- Cristal and Realistic Vue
- fetal pathology
- fetoscopic laser photocoagulation
- monochorionic/monoamiotic twins
- TRAP sequence
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Pathology and Forensic Medicine
Cite this
TRAP Sequence in Monochorionic/Monoamniotic (MC/MA) Discordant Twins : Two Cases Treated with Fetoscopic Laser Surgery. / Tonni, Gabriele; Grisolia, Gianpaolo; Zampriolo, Paolo; Prefumo, Federico; Fichera, Anna; Bonasoni, Paola; Lefebvre, Mathilde; Khung-Savatovsky, Suonavy; Guimiot, Fabien; Rosenblatt, Jonathan; Júnior, Edward Araujo.
In: Fetal and Pediatric Pathology, 01.01.2019.Research output: Contribution to journal › Article
}
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
UR - http://www.scopus.com/inward/record.url?scp=85060028418&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85060028418&partnerID=8YFLogxK
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 -