Prenatal Ultrasound Diagnosis and Outcome of Monochorionic Triplets with Reverse Arterial Perfusion Syndrome: а Clinical Case

Objective . To analyze the possibilities of prenatal ultrasound diagnosis of reverse arterial perfusion (TRAP) sequence in monochorionic triplets using a clinical case. Materials and Methods . The paper presents the results of ultrasound examination and subsequent follow-up of a patient with monochorionic triplets whose pregnancy was complicated by TRAP sequence. TRAP sequence was diagnosed at the initial visit to the Ultrasound Diagnostics Department of the E. M. Bakunina Regional Clinical Perinatal Center (Tver). The patient was referred from a women’s health clinic in Rzhev due to fetal developmental anomalies in twins and a complicated obstetric history. Results . The main and additional ultrasound signs of TRAP sequence allowed timely diagnosis and determination of further pregnancy management. During ultrasound examination, special attention was paid to assessing the risk of heart failure in the pump fetus. Conclusion . Ultrasound is the primary method for diagnosing monochorionic multiple pregnancy and TRAP sequence. Monochorionic multiple pregnancy complicated by TRAP sequence requires dynamic monitoring and detailed echographic control.