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Observations and Remarks on Three Cases of TRAP Sequence

  • E. Fulcheri (a1), C. Carli (a2), G. Garlaschi (a3), S. Malvasio (a4), M.F. Pantarotto (a4) and A. Badini (a4)...

Abstract

Three cases of acardius amorphus with twin reversed arterial perfusion (TRAP) sequences are reported and the histomorphological and clinical aspects are discussed. The patho-physiology of the twin pump is briefly described. Precise prenatal assessment of the morphology of the acardius is recommended for an accurate monitoring of the perfuser in order to plan proper fetal therapy and timing for delivery.

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Copyright

Corresponding author

Istituto di Anatomia e Istologia, Patologica dell'Università di Genova, Via De Toni 14, 16132 Genova, Italia

References

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1. Fries, MH, Goldberg, JD, Golbus, MS (1992): Treatment of acardiac-acephalus twin gestations by hysterectomy and selective delivery. Obstet Gynecol 79:601604.
2. Fusi, L, Fisk, N, Talbert, D, Gau, G, Rodeck, C (1990): When does death occur in an acardiac twin? Ultrasound diagnostic difficulties. J Perinat Med 18:223227.
3. Harrison, SD, Cyr, DR, Patten, RM, Mack, LA (1993): Twin growth problems: causes and sonographic analysis. Semin Ultrasound CT-MR 14:5667.
4. Lachman, R, McNabb, M, Furmanski, M, Karp, L (1980): The acardiac monster. Eur J Pediatr 134:195200.
5. Moore, TR, Gale, S, Benirschke, K (1990): Perinatal outcome of forty-nine pregnancies complicated by acardiac twinning. Am J Obstet Gynecol 163:907912.
6. Nielson, JP, Hood, VD, Cupples, W (1982): Ultrasonic evaluation of twin pregnancies associated with raised serum alpha-fetoprotein levels. Acta Genet Med Gemellol 31:229233.
7. Sarandria, C, Vestita, E, Di Comite, A (1987): Foetus acardius amorphus: rilievi anatomopatologici su di un caso. Neonatologica 3:257261.
8. Van Allen, M, Smith, DW, Shepard, TH (1983): Twin reversed arterial perfusion (TRAP) sequence: study of 14 twin pregnancies with acardius. Semin Perinatol 7:285293.

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