TRAP Sequence in an IVF Pregnancy Successfully Treated with Laser Coagulation: Case Report

JOURNAL TITLE: Journal of Obstetric and Gynaecological Practices POGS

Author
1. Amol Lunkad
2. Ishita Lunkad
3. Amit Magdum
ISSN
DOI
10.5005/jogyp-11012-0001
Volume
1
Issue
1
Publishing Year
2023
Pages
3
Author Affiliations
    1. Department of Reproductive Medicine, Indira IVF Hospital, Pune, Maharashtra, India
    1. Department of Reproductive Medicine, Indira IVF Hospital, Pune, Maharashtra, India
    1. Department to Fetal Medicine, Indira IVF Hospital, Pune, Maharashtra, India
  • Article keywords
    Case report, Diamniotic monochorionic twin pregnancy, Intrauterine laser coagulation, Twin pregnancy, Twin reversed arterial perfusion sequence

    Abstract

    Aim and background: Twin reversed arterial perfusion (TRAP sequence) is a rare condition of monochorionic twin pregnancies in which one twin does the work of supplying blood for both twins. The twin supplying blood is known as the ‘Pump twin’, the other twin is known as the ‘Acardiac twin’ – lacks a heart or has one that is not fully formed. Incidence is 1/35,000 births and 1/100 monochorionic twin pregnancies. Case presentation: Herein, we report a case of TRAP sequence in an in-vitro fertilization (IVF) monochorionic twin pregnancy, which was successfully managed by intrauterine laser coagulation of the umbilical cord of the acardiac twin finally resulting in a live birth at 36 weeks of pregnancy. Conclusion: Twin reversed arterial perfusion sequence is a complication that is seen in monochorionic twin pregnancy, and it has a poor prognosis. Clinical significance: Early selection of proper treatment modality by making the diagnosis with ultrasonography is of great importance for a successful pregnancy outcome.

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