TRAP Sequence in Monochorionic/Monoamniotic (MC/MA) Discordant Twins: Two Cases Treated with Fetoscopic Laser Surgery

Gabriele Tonni; Gianpaolo Grisolia; Paolo Zampriolo; Federico Prefumo; Anna Fichera; Paola Bonasoni; Mathilde Lefebvre; Suonavy Khung-Savatovsky; Fabien Guimiot; Jonathan Rosenblatt; Edward Araujo Júnior

doi:10.1080/15513815.2018.1526240

TRAP Sequence in Monochorionic/Monoamniotic (MC/MA) Discordant Twins: Two Cases Treated with Fetoscopic Laser Surgery

Gabriele Tonni, Gianpaolo Grisolia, Paolo Zampriolo, Federico Prefumo, Anna Fichera, Paola Bonasoni, Mathilde Lefebvre, Suonavy Khung-Savatovsky, Fabien Guimiot, Jonathan Rosenblatt, Edward Araujo Júnior

Research output: Contribution to journal › Article

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	https://doi.org/10.1080/15513815.2018.1526240
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

Tonni, G., Grisolia, G., Zampriolo, P., Prefumo, F., Fichera, A., Bonasoni, P., Lefebvre, M., Khung-Savatovsky, S., Guimiot, F., Rosenblatt, J., & Júnior, E. A. (Accepted/In press). TRAP Sequence in Monochorionic/Monoamniotic (MC/MA) Discordant Twins: Two Cases Treated with Fetoscopic Laser Surgery. Fetal and Pediatric Pathology. https://doi.org/10.1080/15513815.2018.1526240

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

Tonni, Gabriele ; Grisolia, Gianpaolo ; Zampriolo, Paolo ; Prefumo, Federico ; Fichera, Anna ; Bonasoni, Paola ; Lefebvre, Mathilde ; Khung-Savatovsky, Suonavy ; Guimiot, Fabien ; Rosenblatt, Jonathan ; Júnior, Edward Araujo. / TRAP Sequence in Monochorionic/Monoamniotic (MC/MA) Discordant Twins : Two Cases Treated with Fetoscopic Laser Surgery. In: Fetal and Pediatric Pathology. 2019.

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Access to Document

10.1080/15513815.2018.1526240