Key result
Laser coagulation of the umbilical cord by operative microendoscopy successfully arrested blood flow in the acardiac twin, allowing the surviving twin to develop normally.
Why the study?
Does laser coagulation of the umbilical cord under sonoendoscopic control arrest blood flow and allow normal development of the survivor in monochorionic twin pregnancies complicated by TRAP sequence?
Case Report (n=1)
Does laser coagulation of the umbilical cord under sonoendoscopic control arrest blood flow and allow normal development of the survivor in monochorionic twin pregnancies complicated by TRAP sequence?
Laser coagulation of the umbilical cord under sonoendoscopic control is a feasible technique for selective fetocide in early second trimester TRAP sequence.
May support sonoendoscopic laser coagulation for early TRAP sequence; hypothesis-generating and requires prospective validation before practice change.
Twin reversed arterial perfusion (TRAP) sequence carries high mortality and morbidity in the normal twin due to a hemodynamic imbalance through the feto-fetal vascular anastomosis. This report describes the ultrasound features of TRAP in the first trimester and a new technique for selective fetocide in the early second trimester in monochorionic twin pregnancies complicated by the TRAP sequence. Laser coagulation of the umbilical cord of the acardiac twin was performed under sonoendoscopic control. The blood flow in the umbilical cord of the acardiac twin was successfully arrested and the survivor developed normally. TRAP sequence can be recognized in the first trimester and successfully arrested by microendoscopic surgery.
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Hecher et al. (1997) conducted a case report in Twin reversed arterial perfusion (TRAP) sequence (n=1). Laser coagulation of the umbilical cord by operative microendoscopy was evaluated on Arrest of blood flow in the umbilical cord of the acardiac twin and normal development of the survivor. Laser coagulation of the umbilical cord by operative microendoscopy successfully arrested blood flow in the acardiac twin, allowing the surviving twin to develop normally.
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