{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T06:27:43Z","timestamp":1784356063661,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,7,6]],"date-time":"2017-07-06T00:00:00Z","timestamp":1499299200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the outcome of first\u2010trimester intervention (12\u2009+\u20090 to 14\u2009+\u20090\u2009weeks of gestation) in pregnancies complicated by twin reversed arterial perfusion (<jats:styled-content style=\"fixed-case\">TRAP<\/jats:styled-content>) sequence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All monochorionic diamniotic twin pregnancies diagnosed with <jats:styled-content style=\"fixed-case\">TRAP<\/jats:styled-content> sequence that underwent intrafetal laser ablation (<jats:styled-content style=\"fixed-case\">IFL<\/jats:styled-content>) of the feeding vessels before 14\u2009+\u20090\u2009weeks of gestation at the University of Bonn between 2010 and 2015 were analyzed retrospectively for intrauterine course and outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the study period, 12 pregnancies with <jats:styled-content style=\"fixed-case\">TRAP<\/jats:styled-content> sequence were treated by <jats:styled-content style=\"fixed-case\">IFL<\/jats:styled-content>. Median gestational age at intervention was 13.2 (interquartile range (IQR), 12.6\u201313.6)\u2009weeks. In all cases, one intervention sufficed to disrupt the perfusion of the <jats:styled-content style=\"fixed-case\">TRAP<\/jats:styled-content> twin. There was no case of miscarriage, preterm prelabor rupture of membranes or hemorrhage. In five (41.7%) pregnancies, intrauterine death of the pump twin occurred at a median of 72.0 (IQR, 54.0\u201390.0; range, 48\u201396)\u2009h after intervention. The remaining seven pregnancies continued uneventfully resulting in birth of a healthy infant at term. A comparison of survivors and non\u2010survivors identified a significant difference in median discordance between crown\u2013rump length (<jats:styled-content style=\"fixed-case\">CRL<\/jats:styled-content>) of the pump twin and upper pole\u2013rump length (<jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>) of the <jats:styled-content style=\"fixed-case\">TRAP<\/jats:styled-content> twin ((<jats:styled-content style=\"fixed-case\">CRL<\/jats:styled-content>\u2009\u2212\u2009<jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>)\/<jats:styled-content style=\"fixed-case\">CRL<\/jats:styled-content> ratio, 0.56 <jats:italic>vs<\/jats:italic> 0.31; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05 and <jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">CRL<\/jats:styled-content> ratio, 0.44 <jats:italic>vs<\/jats:italic> 0.68; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Survivors were treated at a significantly later gestational age than were non\u2010survivors (median, 13.4 (IQR, 12.9\u201314.1) <jats:italic>vs<\/jats:italic> 12.6 (IQR, 12.5\u201313.1); <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). However, none of these parameters independently predicted survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although technically feasible, <jats:styled-content style=\"fixed-case\">IFL<\/jats:styled-content> performed in the first trimester for <jats:styled-content style=\"fixed-case\">TRAP<\/jats:styled-content> sequence is associated with a significant fetal loss rate. Gestational age at intervention, (<jats:styled-content style=\"fixed-case\">CRL<\/jats:styled-content>\u2009\u2212\u2009<jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>)\/<jats:styled-content style=\"fixed-case\">CRL<\/jats:styled-content> ratio and <jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">CRL<\/jats:styled-content> ratio are potential predictors of pregnancy outcome. Copyright \u00a9 2016 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.16013","type":"journal-article","created":{"date-parts":[[2016,7,8]],"date-time":"2016-07-08T13:39:59Z","timestamp":1467985199000},"page":"40-44","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["First\u2010trimester intervention in twin reversed arterial perfusion sequence: does size matter?"],"prefix":"10.1002","volume":"50","author":[{"given":"M.","family":"Roethlisberger","sequence":"first","affiliation":[{"name":"Division of Prenatal Medicine and Gynecologic Sonography, Department of Obstetrics and Gynecology University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Strizek","sequence":"additional","affiliation":[{"name":"Division of Fetal Surgery, Department of Obstetrics and Prenatal Medicine University of Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Gottschalk","sequence":"additional","affiliation":[{"name":"Division of Prenatal Medicine and Gynecologic Sonography, Department of Obstetrics and Gynecology University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. R.","family":"Mallmann","sequence":"additional","affiliation":[{"name":"Division of Prenatal Medicine and Gynecologic Sonography, Department of Obstetrics and Gynecology University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Geipel","sequence":"additional","affiliation":[{"name":"Division of Fetal Surgery, Department of Obstetrics and Prenatal Medicine University of Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Gembruch","sequence":"additional","affiliation":[{"name":"Division of Fetal Surgery, Department of Obstetrics and Prenatal Medicine University of Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6201-9271","authenticated-orcid":false,"given":"C.","family":"Berg","sequence":"additional","affiliation":[{"name":"Division of Prenatal Medicine and Gynecologic Sonography, Department of Obstetrics and Gynecology University of Cologne  Cologne Germany"},{"name":"Division of Fetal Surgery, Department of Obstetrics and Prenatal Medicine University of Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,6]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.09.025"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.04.018"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(90)91094-S"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000295176"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1040"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3816"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12495"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2001.00250.x"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12578"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000334156"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2025"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000358593"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1994.04060457.x"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13349"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.224"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)91769-8"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000356950"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/15513810801893389"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.16013","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.16013","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.16013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T13:02:36Z","timestamp":1695560556000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.16013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1002\/uog.16013"],"URL":"https:\/\/doi.org\/10.1002\/uog.16013","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7]]},"assertion":[{"value":"2016-03-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-07-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}