A CASE OF TRAP SEQUENCE (ACARDIAC TWIN) TREATMENT WITH CONSERVATIVELY

Abstract

TRAP sequence (twin reversed arterial perfusion) is a complication with a poor prognosis, seen only in monochorionic twin pregnancies, known as acardiac twin formation1. In the very early stages of the formation periods of twin pregnancies, as a result of the single formation of the placenta and the defective formation of the cord vessels of the second baby (acardiac twin), the heart and accordingly the brain development cannot occur in the baby with placenta abnormalities; but other parts of the body can develop in different combinations. Therefore, the second baby can develop from a separate creature to the other baby as a parasite. The normal twin, is known as the pump twin and provides the blood circulation of the acardiac twin. These inter twin anastomoses lead to circulatory confusion, the reverse circulatory morphogenesis interrupted and acardiac twinning occurs2. As the gestational week progresses, the baby grows and develops and this development is accompanied by other parasitic baby. Thus, the baby maintains the blood circulation of the parasitic baby, which is growing both with itself and with her/himself. If the mass development of the other parasitic structure continues in parallel, the heart, which tries to maintain the circulation, may not be able to fulfill this task after a while and fall into failure, and even a healthy baby may be lost for this reason3. This case is presented because the patient had a healthy twin who was born due to the onset of preterm labor that was not terminated at the request of the family, and the other twin with acardiac anencephaly.