James Andrews
Canada
Case Report
Early Radiofrequency Ablation for Twin Reversed Arterial Perfusion TRAP) Sequence: Case Report and Literature Review
Author(s): Kara Aitken, James Andrews, Tim Van Mieghem, Rory Windrim, John Kachura and Greg RyanKara Aitken, James Andrews, Tim Van Mieghem, Rory Windrim, John Kachura and Greg Ryan
Background: High output cardiac failure resulting in fetal death or severe prematurity is a common complication of twin reversed arterial perfusion (TRAP) sequence. Various minimally invasive prenatal interventions have been proposed to improve outcomes for the pump fetus. Uncertainty still exists regarding the optimal timing of these interventions. Early intervention may protect the pump twin against prematurity from complications of cardiac failure or unexpected fetal death, although it carries a risk of procedure related pregnancy loss. Expectant management with surveillance and performing an intervention later in gestation if necessary’ would potentially avoid some procedures but does not protect against unexpected fetal death.
Case: A healthy 30 year-old woman, gravida 2 para 1, was diagnosed with TRAP sequence at 13+1 weeks gesta.. View More»
