{"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":1784356063654,"version":"3.55.0"},"reference-count":10,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ultraschall Med"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Purpose\u2002To evaluate the outcome of first trimester intervention by intrafetal laser (IFL) in pregnancies complicated by twin reversed arterial perfusion (TRAP).<\/jats:p><jats:p>\n          Materials and Methods\u2002For a 10-year study period, all patients with TRAP diagnosed &lt;\u200a14.0 weeks of gestation were retrospectively analyzed for intrauterine course and outcome. Monoamniotic pregnancies were excluded. Patients were offered either intervention by IFL in the first trimester, expectant management, or termination of pregnancy (TOP). Adverse outcome was defined as either intrauterine death (IUD), neonatal death, or preterm birth.<\/jats:p><jats:p>\n          Results\u2002In 45 cases TRAP was diagnosed. 17 monoamniotics were excluded. The cohort was divided into two groups according to management. Group A: 24 cases underwent IFL and group B: 4 cases were managed expectantly. No patient opted for TOP. In group A, 70.8\u200a% of pump twins were born alive, including one preterm delivery, and 29.2\u200a% died within four days after the intervention. All 4 expectantly managed cases in group B had an adverse outcome (1 preterm delivery, 3 IUDs &lt;\u200a15.0 weeks). There were no neonatal deaths. In cases treated by IFL, a comparison of survivors and non-survivors identified no significant differences in gestational age at IFL or any of the assessed biometrical and functional parameters. There was a trend towards better outcome in the second half of the study period.<\/jats:p><jats:p>\n          Conclusion\u2002IFL in first trimester TRAP sequence is technically feasible but is associated with significant mortality, albeit less than previously reported. No risk stratification is possible using the investigated parameters. However, there seems to be a learning curve.<\/jats:p>","DOI":"10.1055\/a-1526-1775","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T22:48:01Z","timestamp":1625006881000},"page":"614-618","source":"Crossref","is-referenced-by-count":10,"title":["Outcome of TRAP Sequence Treated in the First Trimester \u2013 A Ten-Year Single-Center Experience"],"prefix":"10.1055","volume":"43","author":[{"given":"Eva Christin","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9135-4338","authenticated-orcid":false,"given":"Florian","family":"Recker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo","family":"Gottschalk","sequence":"additional","affiliation":[{"name":"Department of Prenatal Medicine, University Hospital Cologne, K\u00f6ln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3625-7097","authenticated-orcid":false,"given":"Brigitte","family":"Strizek","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annegret","family":"Geipel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Gembruch","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Berg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Germany"},{"name":"Department of Prenatal Medicine, University Hospital Cologne, K\u00f6ln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,6,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1002\/bdra.23405","article-title":"Twin reversed arterial perfusion sequence is more common than generally accepted: Twin Reversed Arterial Perfusion Sequence","volume":"103","author":"M JC van Gemert","year":"2015","journal-title":"Birth Defects Research Part A: Clinical and Molecular Teratology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1016\/0002-9378(90)91094-S","article-title":"Perinatal outcome of forty-nine pregnancies complicated by acardiac twinning","volume":"163","author":"T R Moore","year":"1990","journal-title":"American Journal of Obstetrics and Gynecology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1002\/uog.3816","article-title":"Twin reversed arterial perfusion: fetoscopic laser coagulation of placental anastomoses or the umbilical cord","volume":"28","author":"K Hecher","year":"2006","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"213.e1","DOI":"10.1016\/j.ajog.2010.04.018","article-title":"The outcome of twin reversed arterial perfusion sequence diagnosed in the first trimester","volume":"203","author":"L Lewi","year":"2010","journal-title":"American Journal of Obstetrics and Gynecology"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1002\/uog.12495","article-title":"Intrafetal laser treatment for twin reversed arterial perfusion sequence: cohort study and meta-analysis: Intrafetal laser for TRAP sequence: systematic review","volume":"42","author":"G Pagani","year":"2013","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1002\/uog.16013","article-title":"First-trimester intervention in twin reversed arterial perfusion sequence: does size matter?: First-trimester intervention in TRAP sequence","volume":"50","author":"M Roethlisberger","year":"2017","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1002\/uog.20860","article-title":"First\u2010trimester intervention in twin reversed arterial perfusion sequence","volume":"55","author":"M Tavares de Sousa","year":"2020","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1002\/uog.12578","article-title":"Early vs late intervention in twin reversed arterial perfusion sequence: Twin reversed arterial perfusion","volume":"43","author":"C Berg","year":"2014","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1159\/000358593","article-title":"Optimal Method and Timing of Intrauterine Intervention in Twin Reversed Arterial Perfusion Sequence: Case Study and Meta-Analysis","volume":"35","author":"P Chaveeva","year":"2014","journal-title":"Fetal Diagn Ther"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1002\/uog.18834","article-title":"Intrafetal laser ablation for embryo reduction from dichorionic triplets to dichorionic twins","volume":"50","author":"P Chaveeva","year":"2017","journal-title":"Ultrasound Obstet Gynecol"}],"container-title":["Ultraschall in der Medizin - European Journal of Ultrasound"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1526-1775.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T15:17:11Z","timestamp":1676042231000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1526-1775"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,29]]},"references-count":10,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2022,12,5]]},"published-print":{"date-parts":[[2022,12]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1526-1775","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0172-4614","1438-8782"],"issn-type":[{"value":"0172-4614","type":"print"},{"value":"1438-8782","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,29]]}}}