Twin Reversed Arterial Perfusion Sequence (TRAPS): An Illustrative Series of 13 Cases. (3rd March 2016)

• Record Type: Journal Article
• Authors: Ruiz-Cordero, Roberto; Birusingh, Rhea J.; Pelaez, Liset; Azouz, Michel; Rodriguez, Maria Matilde
• Is Part Of: Fetal and pediatric pathology. Volume 35:Number 2(2016)
• Page Start: 63
• Page End: 80
• Publication Date: 2016-03-03
• Subjects: Acardius -- acephalus -- monochorionic placenta -- monochorionic twins -- twin reversed arterial perfusion sequence -- velamentous cord insertion; TRAPS: Twin reversed arterial perfusion sequence -- VCI: Velamentous cord insertion; Pathology, Molecular -- Periodicals; Pediatrics -- Periodicals; Molecular biology -- Periodicals; Pediatric pathology -- Periodicals; Fetal Diseases -- pathology -- Periodicals; Infant, Newborn, Diseases -- pathology -- Periodicals; Pediatrics -- Periodicals; 618.92007
• DOI: 10.3109/15513815.2015.1131785
• Languages: English
• ISSNs: 1551-3815

Abstract

ABSTRACT: Twin reversed-arterial-perfusion sequence (TRAPS) is a rare and severe complication of monochorionic twin pregnancies. It usually occurs in the setting of monochorionic placentation, when the heart of a normal appearing twin serves as the pump for one or more dysmorphic twins whose head, thoracic organs, and upper extremities do not fully develop or do not develop at all and thus lack cardiac activity. Anomalous vascular placental architecture causes a shift in arterial flow towards the acardiac twin(s). The exact physiopathologic mechanisms that lead to this devastating phenomenon are not well known. We reviewed the maternal history and the surgical pathology reports of the fetuses and placentas of 13 different cases of TRAPS that were collected in a 23-year study period at a single institution. Herein we summarize the characteristic findings and illustrate specific mechanical feto-placental circulation issues that appear to be instrumental in the development of TRAPS.