ultrasound diagnosis of fatal anomalies

MULTIPLE PREGNANCY
Fig. 15.11 Twin reversed arterial perfusion (TRAP
sequence). This demonstrates the site of communication
of the two fetal circulations on the
placental surface.
Fig. 15.12 Twin reversed arterial perfusion (TRAP
sequence). The placenta and fetus after abortion at
22 weeks of gestation.
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2
3
4
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at short intervals is recommended. It is important
to exclude fetal hydrops and cardiac failure
in the “pump twin.” The following therapeutic
options are available: 1, administration of digitalis
to the mother; 2, amniotic fluid aspiration
to reduce polyhydramnios; 3, fetoscopic ligation
of the umbilical cord of the recipient twin. Administration
of indomethacin may also help in case
of hydramnios.
Procedure after birth: Intensive treatment of the
newborn is required, depending on the gestational
age and presence of cardiac insufficiency
or hydrops.
References
Borrell A, Pesarrodona A, Puerto B, Deulofeu P, Fuster JJ,
Fortuny A. Ultrasound diagnostic features of twin
reversed arterial perfusion sequence. Prenat Diagn
1990; 10: 443–8.
Gembruch U, Viski S, Bagamery K, Berg C, Germer U.
Twin reversed arterial perfusion sequence in twinto-twin
transfusion syndrome after the death of the
donor co-twin in the second trimester. Ultrasound
Obstet Gynecol 2001; 17: 153–6.
Mohanty C, Mishra OP, Singh CP, Das BK, Singla PN.
Acardiac anomaly spectrum. Teratology 2000; 62:
356–9.
Osborn P, Gross TL, Shah JJ, Ma L. Prenatal diagnosis of
fetal heart failure in twin reversed arterial perfusion
syndrome. Prenat Diagn 2000; 20: 615–7.
Sanjaghsaz H, Bayram MO, Qureshi F. Twin reversed
arterial perfusion sequence in conjoined, acardiac,
acephalic twins associated with a normal triplet: a
case report. J Reprod Med 1998; 43: 1046–50.
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