PMID- 35466064
OWN - NLM
STAT- MEDLINE
DCOM- 20221122
LR  - 20221122
IS  - 1532-1932 (Electronic)
IS  - 1521-6934 (Linking)
VI  - 84
DP  - 2022 Nov
TI  - Twin reverse arterial perfusion: Timing of intervention.
PG  - 127-142
LID - S1521-6934(22)00045-1 [pii]
LID - 10.1016/j.bpobgyn.2022.03.006 [doi]
AB  - Twin reverse arterial perfusion (TRAP) sequence is a severe anomaly in 
      monochorionic twins where one twin has profound corporeal underdevelopment and 
      acardia. The normal "pump" co-twin provides blood flow to the acardiac twin 
      through placental anastomoses which may lead to cardiac failure and pump twin 
      demise as well as preterm delivery from severe polyhydramnios. Treatments include 
      radiofrequency ablation, bipolar cord coagulation, and intrafetal laser with each 
      aimed at occluding blood flow to the acardiac twin. However, none of these 
      modalities has proven superior in terms of either pump twin survival or 
      minimization of complications, including preterm premature rupture of membranes, 
      preterm birth, or unexpected co-twin demise. The optimal timing of treatment is 
      also unknown, without clear indications for intervention versus expectant 
      management. Very early treatment of TRAP (i.e., <16 weeks) has been proposed to 
      reduce first-trimester demise; however, this approach remains experimental. 
      Further investigation is required to determine the best treatment and timing of 
      intervention for TRAP.
CI  - Copyright (c) 2022. Published by Elsevier Ltd.
FAU - Brock, Clifton O
AU  - Brock CO
AD  - Department of Obstetrics, Gynecology and Reproductive Services, University of 
      Texas Health Science Center at Houston, United States; The Fetal Center at 
      Children's Memorial Hermann Hospital, United States.
FAU - Johnson, Anthony
AU  - Johnson A
AD  - Department of Obstetrics, Gynecology and Reproductive Services, University of 
      Texas Health Science Center at Houston, United States; The Fetal Center at 
      Children's Memorial Hermann Hospital, United States. Electronic address: 
      anthony.johnson@uth.tmc.edu.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220329
PL  - Netherlands
TA  - Best Pract Res Clin Obstet Gynaecol
JT  - Best practice & research. Clinical obstetrics & gynaecology
JID - 101121582
SB  - IM
MH  - Pregnancy
MH  - Infant, Newborn
MH  - Female
MH  - Humans
MH  - Placenta
MH  - *Premature Birth
MH  - *Fetofetal Transfusion/surgery
MH  - Pregnancy Reduction, Multifetal
MH  - *Heart Defects, Congenital
MH  - Perfusion
OTO - NOTNLM
OT  - Bipolar cord coagulation
OT  - Fetal surgery
OT  - Monochorionic twins
OT  - Radiofrequency ablation
OT  - Selective reduction
OT  - Twin reverse arterial perfusion sequence
COIS- Declaration of competing interest The authors, Clifton Brock, MD and Anthony 
      Johnson, DO have no conflicts of interest to reports.
EDAT- 2022/04/26 06:00
MHDA- 2022/11/23 06:00
CRDT- 2022/04/25 05:58
PHST- 2022/02/02 00:00 [received]
PHST- 2022/03/13 00:00 [accepted]
PHST- 2022/04/26 06:00 [pubmed]
PHST- 2022/11/23 06:00 [medline]
PHST- 2022/04/25 05:58 [entrez]
AID - S1521-6934(22)00045-1 [pii]
AID - 10.1016/j.bpobgyn.2022.03.006 [doi]
PST - ppublish
SO  - Best Pract Res Clin Obstet Gynaecol. 2022 Nov;84:127-142. doi: 
      10.1016/j.bpobgyn.2022.03.006. Epub 2022 Mar 29.