TRAP sequence; case report

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  • Metin Şentürk



TRAP sequence, monochorionic twin, acardiac fetus


TRAP sequence is a syndrome with poor prognosis seen in monochorionic twin pregnancies at the rate of 1/100. There is an acardiac “nonviable” fetus with multiple anomalies in the TRAP sequence and a pump fetus feeding this fetus through vascular anastomoses in the placenta. Mortality for acardiac twins is 100%. The mortality of the pump twin is around 50%, and death may be generally due to high flow rate heart failure and sometimes prematurity caused by polyhydramnios. Here, we presented an acardiac acephalous type TRAP case that applied to the Obstetrics and Gynecology Clinic of Amasya University Sabuncuoğlu Şerefeddin Training and Research Hospital. The case was 30 years old. The patient had the first pregnancy and reached this pregnancy with the IVF method. She did not have any disease. During the measurement of NT, the fetus of acardiac acephalous type was detected. Laser ablation was performed at the outer center at 18 weeks. All subsequent follow-ups were done by our center. While the patient had 39 weeks and 2 days of pregnancy, the pregnancy was terminated by performing cesarean due to primipara breech arrival.

Author Biography

Metin Şentürk

Kastamonu Training and Research Hospital, Consultant doctor of Gynecology and Obstetrics, Kastamonu, Turkey


Van Allen MI, Smith DW, Shepard TH. Twin reversed arterial perfusion (TRAP) sequence: a study of 14 twin pregnancies with acardius. Semin Perinatol 1983; 7: 285-93.

Smith APM. Abnormalities of twin pregnan- cies. In: Twining P, Hugo J, Pilling P.W eds. Textbook of Fetal Abnormalities.1st ed. London: Churchil Livingstone; 2000. p.404- 5.

Koç A. Çoğul gebelikler.Beksaç S, Demir N, Koç A, Yüksel A editörler. Obstetrik Maternal Fetal Tıp ve Perinatoloji. 1. baskı. Ankara: MN Medikal & Nobel Tıp Kitabevleri; 2001. p.1127.

Hecher K, Ville Y, Nicolaides KH. Color Doppler ultrasonography in the identification of communicating vessels in twin-twin transfusion syndrome and acardiac twins. J Ultrasound Med 1995; 14: 37-40.

Wong EA, SepulvedaW.Acardiac anomaly: current issues in prenatal assessment and treatment. Prenat Diagn 2005; 25: 796- 806.

Moore TR, Gale S,Benirschke K : Perinatal outcomeof fortynine pregnancies complicated by acardiac twinning. Am J Obstet Gynecol 1990; 163 : 907-12 .

Schwarzler P, Ville Y, Moscosco G, et al. Diagnosis of twin reversed arterial perfusion sequence in the first trimesterby transvaginal color doppler ultrasound. Ultrasound obstet Gynecol 1999; 13: 143-6.

Yıldırım E. Spontaneous triplet pregnancy and trap sequence, case report. BMC Pregnancy Childbirth. 2019; 19: 328.

Mone F, Devaseelan P, Ong S. Intervention versus a conservative approach in the management of TRAP sequence: a systematic review. J Perinat Med 2016; 44: 619-29.




How to Cite

Şentürk, M. (2022). TRAP sequence; case report. Kastamonu Medical Journal, 1(4), 110–112.

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