title: Indirect pump: unique presentation of a monochorionic-triamniotic triplet gestation complicated by TRAP sequence and successfully managed with radiofrequency ablation of the acardiac fetus.
abstract: Twin reversed arterial perfusion (TRAP) sequence is a rare complication of multiple gestations. Only a few cases of TRAP sequence in monochorionic triplets have been reported. Here we report a case of TRAP sequence in a monochorionic-triamniotic triplet gestation treated with radiofrequency ablation of the acardiac fetus. The response to the radiofrequency ablation procedure and subsequent examination of the placenta support the hypothesis of an 'indirect' pump triplet.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Medicine, Division of Maternal-Fetal Medicine, University of Texas School of Medicine at Houston, The Texas Fetal Center, Children's Memorial Hermann Hospital, Houston, TX, USA. Pedro.Argoti@uth.tmc.edu
authors.forename: P S
authors.initials: PS
authors.lastname: Argoti
authors.forename: M W
authors.initials: MW
authors.lastname: Bebbington
authors.forename: A
authors.initials: A
authors.lastname: Johnson
authors.forename: K J
authors.initials: KJ
authors.lastname: Moise
mesh_terms: D017115:Catheter Ablation / Q000379:methods; D002675:Child, Preschool; D005260:Female; D005318:Fetal Heart / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology*; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D010920:Placenta / Q000098:blood supply / Q000473:pathology*; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal / Q000379:methods*; D016896:Treatment Outcome; D014310:Triplets; D016216:Ultrasonography, Prenatal