Twin pregnancy complicated with TRAP syndrome: case report and literature update.

Introduction. Reverse arterial perfusion syndrome, known as acardiac twins, complicates approximately 1% of monocorionic twins, 75% occurring in pairs of diamniotic twins and 25% in pairs of monoamniotic twins. If TRAP is not treated properly, the mortality rate of the twin pump is greater than 55%. Materials and method. Presentation of a case with complicated twin pregnancy with TRAP syndrome. Results. A 23-yearold pregnant woman, gesta I, para I, is diagnosed at 14 weeks with a monochorionic diamniotic twin pregnancy from which an acardiac twin. The patient is investigated according to the protocol and followed-up by ultrasound every 2 weeks. The development of the twin pump was normal during pregnancy, the acardiac twin developing oligoamnios at 28 weeks, which prevented the practice of intrauterine intervention. It is decided the conservative management with the monitoring of the normal twin. At 34 weeks, the birth is triggered, the result being a live newborn, of female sex, G=2380 g, and an acardiac twin, with G=1660 g. Conclusions. The premature birth of a living, healthy baby, applying conservative management, is the best possible result in this case. To improve the survival rate for donor twins up to 80%, surgery is recommended. [ABSTRACT FROM AUTHOR]