Twin reversed arterial perfusion syndrome: controversial issues of management tactics (literature review and clinical observation)

Objective. To review the current literature and highlight the modern approach to the diagnosis and treatment of twin reverse arterial perfusion syndrome (TRAP).Materials and methods. The study used a literature review from the Medline, Scopus, Web of Science, Google Scholar, PubMed, Wiley, and Cochrane Library databases. A clinical case of reverse arterial perfusion is analyzed.Results. The pathogenesis of the twin arterial perfusion syndrome was considered, and the causes of the error in the diagnosis of TRAP were highlighted. The basic ultrasound criteria for dynamic monitoring and evaluation of prognoses for a healthy fetus have been formed. Possible management tactics for these patients are highlighted, depending on the clinical situation, as well as possible correction methods for the progression of TRAP.Conclusion. An analysis of the literature data has shown that there are different approaches to the monitoring and treatment of TRAP, at the moment there is an unequivocal opinion that early diagnosis, comprehensive monitoring, and timely surgical treatment with the progression of TRAP are necessary. Further study of ultrasound signs of progression of twin arterial perfusion syndrome and the development of clear algorithms for monitoring and surgical treatment will improve perinatal outcomes for a healthy fetus (fetus-pump).