Twin Reversed Arterial Perfusion Sequence (TRAPS): An illustrative series of 13 cases

Roberto Ruiz-Cordero, Rhea J. Birusingh, Liset Pelaez, Michel Azouz, Maria Rodriguez

Research output: Contribution to journalArticle

4 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)63-80
Number of pages18
JournalFetal and Pediatric Pathology
Volume35
Issue number2
DOIs
StatePublished - Mar 3 2016

Fingerprint

Perfusion
Placental Circulation
Placentation
Surgical Pathology
Twin Pregnancy
Upper Extremity
Placenta
Blood Vessels
Fetus
Thorax
Head
Mothers

Keywords

  • Acardius
  • acephalus
  • monochorionic placenta
  • monochorionic twins
  • twin reversed arterial perfusion sequence
  • velamentous cord insertion

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Twin Reversed Arterial Perfusion Sequence (TRAPS) : An illustrative series of 13 cases. / Ruiz-Cordero, Roberto; Birusingh, Rhea J.; Pelaez, Liset; Azouz, Michel; Rodriguez, Maria.

In: Fetal and Pediatric Pathology, Vol. 35, No. 2, 03.03.2016, p. 63-80.

Research output: Contribution to journalArticle

Ruiz-Cordero, R, Birusingh, RJ, Pelaez, L, Azouz, M & Rodriguez, M 2016, 'Twin Reversed Arterial Perfusion Sequence (TRAPS): An illustrative series of 13 cases', Fetal and Pediatric Pathology, vol. 35, no. 2, pp. 63-80. https://doi.org/10.3109/15513815.2015.1131785
Ruiz-Cordero, Roberto ; Birusingh, Rhea J. ; Pelaez, Liset ; Azouz, Michel ; Rodriguez, Maria. / Twin Reversed Arterial Perfusion Sequence (TRAPS) : An illustrative series of 13 cases. In: Fetal and Pediatric Pathology. 2016 ; Vol. 35, No. 2. pp. 63-80.
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