A case report of TRAP Sequence with Preeclampsia and Review of Literature

Abstract

We are reporting a case of the Twin Reversed-Arterial Perfusion (TRAP) sequence, specifically highlighting the autopsy findings of an acardiac twin and the histopathological findings in its placenta. The TRAPsequence or acardiac twining, is an uncommon congenital anomaly involving a grossly abnormal acardiac twin and an otherwise normal pump twin. Thiscomplex congenital anomaly is unique to monochorionicmonozygotic twin gestations. It requires an artery-to-artery(A-A) anastomosis leading to reversal of arterial perfusion with complex pathophysiology. A 19 year-oldgirl delivered twins by C-section at 31 weeks because of preeclampsia and non-reassuring fetal heart tracings. One was a preterm female; the other was an acardiac twin. This is perhaps the first case report of autopsy findings of an acardiac twin pregnancy associated with preeclampsia.