Twin Reversed Arterial Perfusion (TRAP) - My Child Has

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Twin Reversed Arterial Perfusion (TRAP)

Twin Reversed Arterial Perfusion (TRAP)

Programs that treat this condition

Advanced Fetal Care Center

What is Twin Reversed Arterial Perfusion?

Twin reversed arterial perfusion (TRAP) occurs in identical twin pregnancies when one twin has an absent or non-functioning heart (acardiac/acephalic) and receives all of its blood from the normally functioning and developing "pump twin". The twins are joined by a large blood vessel between their umbilical cords. The pump twin's heart works extra hard to pump to the acardiac twin, increasing the pump twin's risk of heart failure and death. The acardiac twin has no chance for survival. In addition, if both twins are in the same amniotic sac (usually), they may get entangled and twist the umbilical cord resulting in sudden death.

Why and how often does TRAP this occur?

The cause of TRAP is unknown. It occurs in approximately 1 in every 35,000 births, and 1% of identical twin pregnancies.

How is TRAP Diagnosed?

TRAP is diagnosed on a prenatal ultrasound. Often the pump twin's size will be larger than the acardiac twin. Also the pump twin may develop polyhydramnios (excessive accumulation of amniotic fluid) and possibly heart failure which can be seen on ultrasound and more closely on fetal echocardiography, which looks directly at the heart of the pump twin.

What is the Treatment for TRAP?

Treatment is aimed at saving the pump twin by separating the circulation between the twins.This involves cutting the umbilical cord of the acardiac twin with umbilical cord ligation. This will increase the chance of survival in the pump twin by decreasing the potential for heart failure and death. The procedure is performed through a single puncture in the mother's abdomen.

There is an increase in the potential for development of preterm labor after this procedure and patients are monitored closely after the procedure.


					Children's Hospital Boston is the primary pediatric teaching hospital of Harvard Medical School

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