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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Twin reversed arterial perfusion (TRAP)
Synonyms
- Acardiac monster
- Cardiac regression sequence
Definitions
- Anomalous twin (TRAP twin) perfused by deoxygenated blood from pump twin
- Blood enters TRAP fetus via umbilical artery (UA)
- Reversed perfusion → selective development of torso/lower extremities
- Lack of umbilical vein flow into heart → impaired/absent cardiac development
IMAGING
General Features
Ultrasonographic Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
- Gabby LC et al: Risk factors for co-twin fetal demise following radiofrequency ablation in multifetal monochorionic gestations. Fetal Diagn Ther. 1-7, 2020
- Shanahan MA et al: Placental anatomy and function in twin gestations. Obstet Gynecol Clin North Am. 47(1):99-116, 2020
- Shettikeri A et al: Outcome of pregnancies diagnosed with TRAP sequence prenatally: a single-centre experience. Fetal Diagn Ther. 47(4):301-6, 2020
- Tavares de Sousa M et al: First-trimester intervention in twin reversed arterial perfusion sequence. Ultrasound Obstet Gynecol. 55(1):47-9, 2020
- Ting YH et al: Outcomes of radiofrequency ablation for selective fetal reduction in complicated monochorionic pregnancies performed before 16 gestational weeks and thereafter. Ultrasound Obstet Gynecol. ePub, 2020
- Jha P et al: US Evaluation of twin pregnancies: Importance of chorionicity and amnionicity. Radiographics. 39(7):2146-66, 2019
- Expert Panel on Women's Imaging:. et al: ACR Appropriateness Criteria® multiple gestations. J Am Coll Radiol. 14(11S):S476-89, 2017
- Roethlisberger M et al: First-trimester intervention in twin reversed arterial perfusion sequence: does size matter? Ultrasound Obstet Gynecol. 50(1):40-4, 2017
- Mone F et al: Intervention versus a conservative approach in the management of TRAP sequence: a systematic review. J Perinat Med. 44(6):619-29, 2016
- Sugibayashi R et al: Forty cases of twin reversed arterial perfusion sequence treated with radio frequency ablation using the multistep coagulation method: a single-center experience. Prenat Diagn. 36(5):437-43, 2016
- van Gemert MJ et al: Acardiac twin pregnancies part III: model simulations. Birth Defects Res A Clin Mol Teratol. 106(12):1008-15, 2016
- van Gemert MJ et al: Hypothesis acardiac twin pregnancies: pathophysiology-based hypotheses suggest risk prediction by pump/acardiac umbilical venous diameter ratios. Birth Defects Res A Clin Mol Teratol. 106(2):114-21, 2016
- Stephenson CD et al: Microwave ablation for twin-reversed arterial perfusion sequence: a novel application of technology. Fetal Diagn Ther. 38(1):35-40, 2015
- Takano M et al: Experience of fetoscopic laser photocoagulation and cord transection for twin-reversed arterial perfusion sequence. J Obstet Gynaecol Res. 41(9):1326-9, 2015
- van Gemert MJ et al: Twin reversed arterial perfusion sequence is more common than generally accepted. Birth Defects Res A Clin Mol Teratol. 103(7):641-3, 2015
- Berg C et al: Twin reversed arterial perfusion (TRAP) sequence--does monoamniocity preclude early intervention? Ultrasound Obstet Gynecol. 44(2):241-2, 2014
- Chaveeva P et al: Optimal method and timing of intrauterine intervention in twin reversed arterial perfusion sequence: case study and meta-analysis. Fetal Diagn Ther. 35(4):267-79, 2014
- Peeters SH et al: Fetal surgery in complicated monoamniotic pregnancies: case series and systematic review of the literature. Prenat Diagn. 34(6):586-91, 2014
- Prefumo F et al: Fetoscopic cord transection for treatment of monoamniotic twin reversed arterial perfusion sequence. Ultrasound Obstet Gynecol. 43(2):234-5, 2014
- Oliver ER et al: Twin reversed arterial perfusion sequence: a new method of parabiotic twin mass estimation correlated with pump twin compromise. J Ultrasound Med. 32(12):2115-23, 2013
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Twin reversed arterial perfusion (TRAP)
Synonyms
- Acardiac monster
- Cardiac regression sequence
Definitions
- Anomalous twin (TRAP twin) perfused by deoxygenated blood from pump twin
- Blood enters TRAP fetus via umbilical artery (UA)
- Reversed perfusion → selective development of torso/lower extremities
- Lack of umbilical vein flow into heart → impaired/absent cardiac development
IMAGING
General Features
Ultrasonographic Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
- Gabby LC et al: Risk factors for co-twin fetal demise following radiofrequency ablation in multifetal monochorionic gestations. Fetal Diagn Ther. 1-7, 2020
- Shanahan MA et al: Placental anatomy and function in twin gestations. Obstet Gynecol Clin North Am. 47(1):99-116, 2020
- Shettikeri A et al: Outcome of pregnancies diagnosed with TRAP sequence prenatally: a single-centre experience. Fetal Diagn Ther. 47(4):301-6, 2020
- Tavares de Sousa M et al: First-trimester intervention in twin reversed arterial perfusion sequence. Ultrasound Obstet Gynecol. 55(1):47-9, 2020
- Ting YH et al: Outcomes of radiofrequency ablation for selective fetal reduction in complicated monochorionic pregnancies performed before 16 gestational weeks and thereafter. Ultrasound Obstet Gynecol. ePub, 2020
- Jha P et al: US Evaluation of twin pregnancies: Importance of chorionicity and amnionicity. Radiographics. 39(7):2146-66, 2019
- Expert Panel on Women's Imaging:. et al: ACR Appropriateness Criteria® multiple gestations. J Am Coll Radiol. 14(11S):S476-89, 2017
- Roethlisberger M et al: First-trimester intervention in twin reversed arterial perfusion sequence: does size matter? Ultrasound Obstet Gynecol. 50(1):40-4, 2017
- Mone F et al: Intervention versus a conservative approach in the management of TRAP sequence: a systematic review. J Perinat Med. 44(6):619-29, 2016
- Sugibayashi R et al: Forty cases of twin reversed arterial perfusion sequence treated with radio frequency ablation using the multistep coagulation method: a single-center experience. Prenat Diagn. 36(5):437-43, 2016
- van Gemert MJ et al: Acardiac twin pregnancies part III: model simulations. Birth Defects Res A Clin Mol Teratol. 106(12):1008-15, 2016
- van Gemert MJ et al: Hypothesis acardiac twin pregnancies: pathophysiology-based hypotheses suggest risk prediction by pump/acardiac umbilical venous diameter ratios. Birth Defects Res A Clin Mol Teratol. 106(2):114-21, 2016
- Stephenson CD et al: Microwave ablation for twin-reversed arterial perfusion sequence: a novel application of technology. Fetal Diagn Ther. 38(1):35-40, 2015
- Takano M et al: Experience of fetoscopic laser photocoagulation and cord transection for twin-reversed arterial perfusion sequence. J Obstet Gynaecol Res. 41(9):1326-9, 2015
- van Gemert MJ et al: Twin reversed arterial perfusion sequence is more common than generally accepted. Birth Defects Res A Clin Mol Teratol. 103(7):641-3, 2015
- Berg C et al: Twin reversed arterial perfusion (TRAP) sequence--does monoamniocity preclude early intervention? Ultrasound Obstet Gynecol. 44(2):241-2, 2014
- Chaveeva P et al: Optimal method and timing of intrauterine intervention in twin reversed arterial perfusion sequence: case study and meta-analysis. Fetal Diagn Ther. 35(4):267-79, 2014
- Peeters SH et al: Fetal surgery in complicated monoamniotic pregnancies: case series and systematic review of the literature. Prenat Diagn. 34(6):586-91, 2014
- Prefumo F et al: Fetoscopic cord transection for treatment of monoamniotic twin reversed arterial perfusion sequence. Ultrasound Obstet Gynecol. 43(2):234-5, 2014
- Oliver ER et al: Twin reversed arterial perfusion sequence: a new method of parabiotic twin mass estimation correlated with pump twin compromise. J Ultrasound Med. 32(12):2115-23, 2013
