{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T18:43:13Z","timestamp":1767897793405,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Twin reversed arterial perfusion (TRAP) sequence is a rare and severe complication of monochorionic twins, occurring in approximately 1 in 35\u2009000 pregnancies. It is characterized by the presence of a severely abnormal, nonviable acardiac twin and a structurally normal pump twin, which sustains the circulation of both fetuses through abnormal vascular placental anastomoses. This pictorial essay aims to illustrate the sonographic and Doppler findings associated with TRAP sequence, emphasizing the diagnostic prenatal features. Typical findings include the absence of cardiac activity in the acardiac twin, structural anomalies such as acardia, acrania, underdeveloped upper body, and paradoxical reversed flow patterns in the umbilical artery. Early diagnosis and close ultrasound monitoring are crucial for selecting antenatal treatment, including expectant management and fetal intervention. By presenting illustrative cases, this article provides a comprehensive overview to bolster the understanding of the different associated phenotypes and recognition of TRAP sequence amongst clinicians and sonographers.<\/jats:p>","DOI":"10.1002\/jcu.23988","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T05:53:10Z","timestamp":1747288390000},"page":"1584-1593","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Twin Reversed Arterial Perfusion (<scp>TRAP<\/scp>) Sequence Phenotypes: A Comprehensive Visual Analysis"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2620-7486","authenticated-orcid":false,"given":"Gabriele","family":"Tonni","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Neonatology, and Researcher Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), ASL Reggio Emilia  Reggio Emilia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5314-7231","authenticated-orcid":false,"given":"Gianpaolo","family":"Grisolia","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Carlo Poma Hospital, ASST  Mantova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1818-0105","authenticated-orcid":false,"given":"Giosu\u00e8 Giordano","family":"Incognito","sequence":"additional","affiliation":[{"name":"Dipartimento di Chirurgia Generale e Specialit\u00e0 Medico Chirurgiche Universit\u00e0 di Catania  Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3856-574X","authenticated-orcid":false,"given":"Waldo","family":"Sepulveda","sequence":"additional","affiliation":[{"name":"FETALMED\u2013Maternal\u2010Fetal Diagnostic Center, Fetal Imaging Unit  Santiago Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3642-5858","authenticated-orcid":false,"given":"Rodrigo","family":"Ruano","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences University of Miami  Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6145-2532","authenticated-orcid":false,"given":"Edward","family":"Araujo J\u00fanior","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Paulista School of Medicine\u2014Federal University of S\u00e3o Paulo (EPM\u2010UNIFESP)  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0571-1520","authenticated-orcid":false,"given":"Marcio Fragoso","family":"Vieira","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Federal University of Cear\u00e1 (UFC)  Fortaleza Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5436-0185","authenticated-orcid":false,"given":"Mario","family":"Lituania","sequence":"additional","affiliation":[{"name":"Preconceptional and Prenatal Pathophysiology, Department of Obstetrics and Gynecology E.O. 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