Secuencia TRAP: diagnóstico, opciones de tratamiento y experiencia propia

Abstract

Twin reversed arterial perfusion syndrome or TRAP sequence is a rare and exclusive complication of monochorionic pregnancies. It is characterized by the presence of a malformed fetus whose heart is rudimentary or absent, and has no direct placental perfusion, but its blood flow is coming through a direct A-A (A-A) comunication from the structurally normal co-twin, (pump twin), and then after perfusing to the acardiac one, double deoxygenated blood returns to the pump twin through a veno-venous connection (V-V).The natural history of the disease is death from heart failure of the pump twin in 35-55% of the cases.The purpose of this paper is to review the basics aspect and the current status of this condition, focusing primarily on diagnosis, management options, prenatal invasive treatment alternatives, and to present a review of our experience.