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Ultrasonic identification of pump twin by dual-gate Doppler in a monochorionic-triamniotic triplet twin reversed arterial perfusion sequence before preventative radiofrequency ablation: a case report

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Abstract

We performed a dual-gate Doppler examination for a twin reversed arterial perfusion (TRAP) sequence in a monochorionic-triamniotic triplet pregnancy at 16 weeks of gestation and were able to identify the pump twin by arterial pulse rate synchronicity. We performed radiofrequency ablation to coagulate blood flow in the acardius at 16 weeks of gestation without any postoperative complication. At 29 weeks of gestation, we performed a cesarean section due to preterm rupture of the membranes and the patient delivered 1167/1237-g female neonates and a macerated acardius. Examination of the placenta revealed two thickened vessels from the pump twin to the acardius, which had been prenatally identified by dual-gate Doppler. This new technology launches the new field of noninvasive fetal identification for triplet TRAP sequence.

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Authors and Affiliations

  1. Department of Fetal-Maternal Medicine, Nagara Medical Center, 1300-7, Nagara, Gifu, 502-87558, Japan

    Yuichiro Takahashi, Shigenori Iwagaki, Rika Chiaki, Kazuhiko Asai, Masako Matsui & Ichiro Kawabata

Authors
  1. Yuichiro Takahashi
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  2. Shigenori Iwagaki
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  3. Rika Chiaki
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  4. Kazuhiko Asai
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  5. Masako Matsui
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  6. Ichiro Kawabata
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Corresponding author

Correspondence to Yuichiro Takahashi.

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Conflict of interest

The authors declare that there is no conflict of interest.

Ethical statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Takahashi, Y., Iwagaki, S., Chiaki, R. et al. Ultrasonic identification of pump twin by dual-gate Doppler in a monochorionic-triamniotic triplet twin reversed arterial perfusion sequence before preventative radiofrequency ablation: a case report. J Med Ultrasonics 45, 185–187 (2018). https://doi.org/10.1007/s10396-017-0792-7

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  • DOI: https://doi.org/10.1007/s10396-017-0792-7

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