| Peer-Reviewed

Twin Reversed Arterial Perfusion (TRAP) Sequence: A Case Report in Fallujah Maternity and Children Hospital, Fallujah, Iraq

Received: 21 July 2015     Accepted: 31 July 2015     Published: 10 August 2015
Views:       Downloads:
Abstract

Introduction. Twin reversed arterial perfusion (TRAP) sequence is a rare complication of multiple pregnancy caused by defects in early embryogenesis. The pump twin supplies the acardiac recipient twin with blood, and although the pump twin is usually structurally normal, congenital anomalies have sometimes been reported. We report a case of twin reversed arterial perfusion sequence with feet polydactly in the surviving pump twin. This was the 1st case reported in Fallujah city, Iraq. Case report. A 22 years old. gravida 2, para 0. abortion 1, full term lady presented to the delivery room with labour pain with no history of any prenatal care. She gave no history of any familial congenital anomaly and there was no history of consanguinity with her hasbund. She has been referred for cesearian section delivery as an emergency as there was no progress in labour. Ultrasound examination at the delivery room revealed the diagnosis of monozygotic twin, one was normal & the 2nd was diagnosed as (abnormal) with difficulty in visualization of the fetal parts and gender. Conclusion. Twin-Reversed Arterial Perfusion (TRAP) sequence is a rare complication of monozygotic multiple gestation. Accurate antenatal diagnosis is essential to improve the prognosis of this rare entity.

Published in Clinical Medicine Research (Volume 4, Issue 5)
DOI 10.11648/j.cmr.20150405.15
Page(s) 151-153
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

TRAP Sequence, Twin Pregnancy, Polydactly, Fallujah

References
[1] Healey M: Acardia: predictive risk factors for the co-twin’s survival. Teratology 1994, 50:205-213.
[2] Gembruch U, Viski S, Bagamery K, Berg C, Germer U: Twin reversed arterial perfusion sequence in twin-to-twin transfusion syndrome after the death of the donor co-twin in the second trimester. Ultrasound Obstet Gynecol 2001, 17: 153-156.
[3] Chen CY, Wu YC, Chen CL, Yang ML: Acardiac syndrome coexisting with complex skeletal dysplasia in the co-twin: 3 D sonographic findings. J Clin Ultrasound 2007, 35:387-389.
[4] www.nlm.nih.gov/.../003176. United States National Library of Medicine.
[5] Alaani S, Al-Fallouji M, Busby C, Hamdan M: Pilot Study of Congenital Anomaly Rates at Birth in Fallujah, Iraq, 2010. JIMA: Vol 44, 2012. http://dx.doi.org/10.5915/44-1-10463.
[6] Busby C, Hamdan M, Ariabi E. Cancer, infant mortality and birth sex-ratio in Fallujah, Iraq 2005-2009. Int J Environ Res Public Health. 2010;7:2828-37. http://doi.org/ck8j8z.
[7] Alaani S, Savabieasfahani M, Tafash M et al. Four polygamous families with congenital birth defects from Fallujah Iraq. Int J Environ Res Public Health. 2011; 8: 89-96. http://dx.doi.org/10.3390/ijerph8010089
[8] Alaani S, Tafash M, Busby C, et al. Uranium and other contaminants in hair from the parents of children with congenital anomalies in Fallujah, Iraq. Confl Health. 2011; 5: 15. http://dx.doi.org/10.1186/1752-1505-5-15.
[9] Mohanty C, Mishra OP, Singh CP, et al. Acardiac Anomaly Spectrum. Tetralogy 2000; 62: 356-9.
[10] Shashidhar B. B N kishore kumar. R.Sheela. R.Kalyani. N. Anithae, Prem Sai Reddy. Twin reversed arterial perfusion (TRAP) Sequence: (Acardius Amorphous) a case report and review of literature. Int J Biol Med Res. 2012; 3(1): 1453-1455.
[11] Gembruch U, Viski S, Bagamery K, et al. Twin Reversed Arterial Perfusion Sequence in Twin- to-Twin Transfusion Syndrome after the Death of the Donor Co-Twin in the Second Trimester. Ultrasound Obstet Gynecol 2001; 17: 153-6.
[12] Luiz N. TRAP Syndrome. Indian Pediatr 2003; 40: 683-4.
[13] Weisz B, Peltz R, Chayen B, et al. Tailored Management of Twin Reversed Arterial Perfusion (TRAP) Sequence. Ultrasound Obstet Gynecol 2004; 23: 451-5.
[14] Gibson JY, D'Cruz CA, Patel RB, et al. Acardiac Anomaly: Review of the Subject with Case Report and Emphasis on Practical Sonography. J Clin Ultrasound 1986; 14: 541-5.
[15] Izquierdo L, Smith J, Gilson G, et al. Twin, Acardiac, Acephalus. Fetus 1991; 1: 1-3.
[16] Tan TYT, Sepulveda W. Acardiac twin: A systematic review of minimally invasive treatment modalities Ultrasound Obstet Gynecol. 2003; 22: 409–419.
[17] Ishimatsu J, Nakanami H, Hamada T, Yakushiji M. Color and pulsed Doppler ultrasonography of reversed umbilical blood flow in an acardiactwin. Asia Oceania J Obstet Gynaecol. 1993; 19: 271–275.
Cite This Article
  • APA Style

    Samira T. Abdulghani Alaani. (2015). Twin Reversed Arterial Perfusion (TRAP) Sequence: A Case Report in Fallujah Maternity and Children Hospital, Fallujah, Iraq. Clinical Medicine Research, 4(5), 151-153. https://doi.org/10.11648/j.cmr.20150405.15

    Copy | Download

    ACS Style

    Samira T. Abdulghani Alaani. Twin Reversed Arterial Perfusion (TRAP) Sequence: A Case Report in Fallujah Maternity and Children Hospital, Fallujah, Iraq. Clin. Med. Res. 2015, 4(5), 151-153. doi: 10.11648/j.cmr.20150405.15

    Copy | Download

    AMA Style

    Samira T. Abdulghani Alaani. Twin Reversed Arterial Perfusion (TRAP) Sequence: A Case Report in Fallujah Maternity and Children Hospital, Fallujah, Iraq. Clin Med Res. 2015;4(5):151-153. doi: 10.11648/j.cmr.20150405.15

    Copy | Download

  • @article{10.11648/j.cmr.20150405.15,
      author = {Samira T. Abdulghani Alaani},
      title = {Twin Reversed Arterial Perfusion (TRAP) Sequence: A Case Report in Fallujah Maternity and Children Hospital, Fallujah, Iraq},
      journal = {Clinical Medicine Research},
      volume = {4},
      number = {5},
      pages = {151-153},
      doi = {10.11648/j.cmr.20150405.15},
      url = {https://doi.org/10.11648/j.cmr.20150405.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20150405.15},
      abstract = {Introduction. Twin reversed arterial perfusion (TRAP) sequence is a rare complication of multiple pregnancy caused by defects in early embryogenesis. The pump twin supplies the acardiac recipient twin with blood, and although the pump twin is usually structurally normal, congenital anomalies have sometimes been reported. We report a case of twin reversed arterial perfusion sequence with feet polydactly in the surviving pump twin. This was the 1st case reported in Fallujah city, Iraq. Case report. A 22 years old. gravida 2, para 0. abortion 1, full term lady presented to the delivery room with labour pain with no history of any prenatal care. She gave no history of any familial congenital anomaly and there was no history of consanguinity with her hasbund. She has been referred for cesearian section delivery as an emergency as there was no progress in labour. Ultrasound examination at the delivery room revealed the diagnosis of monozygotic twin, one was normal & the 2nd was diagnosed as (abnormal) with difficulty in visualization of the fetal parts and gender. Conclusion. Twin-Reversed Arterial Perfusion (TRAP) sequence is a rare complication of monozygotic multiple gestation. Accurate antenatal diagnosis is essential to improve the prognosis of this rare entity.},
     year = {2015}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Twin Reversed Arterial Perfusion (TRAP) Sequence: A Case Report in Fallujah Maternity and Children Hospital, Fallujah, Iraq
    AU  - Samira T. Abdulghani Alaani
    Y1  - 2015/08/10
    PY  - 2015
    N1  - https://doi.org/10.11648/j.cmr.20150405.15
    DO  - 10.11648/j.cmr.20150405.15
    T2  - Clinical Medicine Research
    JF  - Clinical Medicine Research
    JO  - Clinical Medicine Research
    SP  - 151
    EP  - 153
    PB  - Science Publishing Group
    SN  - 2326-9057
    UR  - https://doi.org/10.11648/j.cmr.20150405.15
    AB  - Introduction. Twin reversed arterial perfusion (TRAP) sequence is a rare complication of multiple pregnancy caused by defects in early embryogenesis. The pump twin supplies the acardiac recipient twin with blood, and although the pump twin is usually structurally normal, congenital anomalies have sometimes been reported. We report a case of twin reversed arterial perfusion sequence with feet polydactly in the surviving pump twin. This was the 1st case reported in Fallujah city, Iraq. Case report. A 22 years old. gravida 2, para 0. abortion 1, full term lady presented to the delivery room with labour pain with no history of any prenatal care. She gave no history of any familial congenital anomaly and there was no history of consanguinity with her hasbund. She has been referred for cesearian section delivery as an emergency as there was no progress in labour. Ultrasound examination at the delivery room revealed the diagnosis of monozygotic twin, one was normal & the 2nd was diagnosed as (abnormal) with difficulty in visualization of the fetal parts and gender. Conclusion. Twin-Reversed Arterial Perfusion (TRAP) sequence is a rare complication of monozygotic multiple gestation. Accurate antenatal diagnosis is essential to improve the prognosis of this rare entity.
    VL  - 4
    IS  - 5
    ER  - 

    Copy | Download

Author Information
  • Central Committee of Birth defects registration and follow up, Fallujah Maternity and Children Hospital, Fallujah, Iraq

  • Sections