{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T04:01:56Z","timestamp":1780286516911,"version":"3.54.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To establish a new classification system for Twin Reversed Arterial Perfusion (TRAP) sequence based on specific skeletal morphological characteristics, and to evaluate its prognostic relevance in expectantly managed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single center retrospective cohort study of TRAP sequence cases between February 2001 and April 2022 that were expectantly managed. Cases were classified into five morphological types: Type I (Hemiacardius), Type II (Acardius Holosomus), Type III (Acephalus Trunk), Type IV (Acephalus Acormus), and Type V (Acardius Amorphous). Pump twin outcomes for prognosis were compared among the five types.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 116 cases expectantly managed, the most common type was type III (41.4%), followed by type II (23.3%), type I (17.2%), type IV (7.8%), and type V (10.3%). Among these 116 cases, 29 (25.0%) had favorable outcomes, whereas 87 (75.0%) had an adverse outcome. Survival rates differed significantly by type (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001): Type V, 66.7% (8\/12); Type IV, 33.3% (3\/9); Type II, 22.2% (6\/27); Type III, 18.8% (9\/48); and Type I, 15.0% (3\/20).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this series of expectantly managed TRAP\u2010cases, pump twin survival was highest when the acardiac twin exhibited minimal structural development. Early sonographic classification may support prenatal counseling in the TRAP sequence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.70125","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T03:05:49Z","timestamp":1774235149000},"page":"475-482","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Twin Reversed Arterial Perfusion (TRAP) Sequence: Proposal for Morphologic Classification System Predicting Natural History"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2067-0375","authenticated-orcid":false,"given":"Li","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Ultrasound Diagnosis Maternal and Child Health Hospital of Hubei Province  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Ultrasound 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5289-6588","authenticated-orcid":false,"given":"Xiao\u2010Hong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Diagnosis Maternal and Child Health Hospital of Hubei Province  Wuhan 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