title: Early diagnosis, follow-up, and prenatal treatment of a case of TRAP sequence occurring in a dichorionic triamniotic triplet pregnancy.
abstract: We are reporting a case of twin reversed arterial perfusion (TRAP) sequence occurring in a dichorionic triamniotic triplet pregnancy with successful percutaneous prenatal treatment and excellent neonatal outcome. TRAP sequence was diagnosed at 11 weeks in a spontaneous dichorionic-triamniotic triplet. Sonographic assessment showed persistent arterial flow and development of hydrops in the acardiac twin. Percutaneous cord interstitial laser coagulation was performed, and the co-twin subsequently developed growth restriction. The 9-month-old twins have a normal developmental course. This report confirms that fetal intervention is indicated in cases of TRAP sequence in which the acardiac twin presents a significant enlargement on follow-up sonographic examinations.
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS San Raffaele, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cavoretto
authors.forename: Audrey
authors.initials: A
authors.lastname: Serafini
authors.forename: Luca
authors.initials: L
authors.lastname: Valsecchi
authors.forename: Mariano
authors.initials: M
authors.lastname: Lanna
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Rustico
mesh_terms: D000328:Adult; D002585:Cesarean Section; D042241:Early Diagnosis; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging* / Q000628:therapy*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging; D006801:Humans; D015160:Hydrops Fetalis / Q000601:surgery; D017075:Laser Coagulation; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal / Q000379:methods*; D011272:Pregnancy, Multiple; D011295:Prenatal Care; D014310:Triplets; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal