Abstract
Abstract To the best of our knowledge, we report the first case of a successful antenatal intervention in a double twin reversed arterial perfusion (TRAP) sequence in a monoamniotic monochorial triplet pregnancy. After diagnosis during first-trimester ultrasound, fetoscopic coagulation and transection of the umbilical cords of both acardiac members was performed at 16 weeks of gestation. The immediate postoperative course was complicated with iatrogenic preterm premature rupture of membranes, which was successfully reversed with an amniopatch procedure. Consequent sonographic assessments showed a healthy fetus with normal growth and development, together with progressive atrophy of the acardiac fetuses. Owing to placental abruption, an urgent cesarean section was performed at 32 weeks. A baby girl of 1600 g was born in good general condition. Except for the butts of the transected umbilical cords, there were no remnants of the TRAP twins to be distinguished. After a neonatal follow up of 64 days, the baby girl could be discharged.
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