{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T08:47:22Z","timestamp":1767084442151,"version":"3.37.3"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T00:00:00Z","timestamp":1596844800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T00:00:00Z","timestamp":1596844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Sistema Nacional de Investigaci\u00f3n","award":["216-2017"],"award-info":[{"award-number":["216-2017"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Twin reversed arterial perfusion sequence is a rare and potentially lethal condition affecting approximately 1% of monochorionic twin pregnancies and 1 in 35,000 pregnancies overall. An apparently normal (pump) twin perfuses its severely malformed cotwin with deoxygenated blood via retrograde flow in direct arterioarterial anastomoses between the umbilical arteries of each twin. Fetal intestinal volvulus is a rare condition usually manifesting after birth. We report a unique case of twin reversed arterial perfusion sequence in association with intestinal volvulus in the surviving pump twin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 32-year-old Hispanic primigravida was referred to our clinic after a fetoscopy procedure of laser photocoagulation of anastomoses at 18\u2009weeks of gestation. Follow up scans in the ex-pump twin revealed dilated bowel loops and a typical \u201cwhirlpool sign\u201d at 26\u2009weeks of gestation, and intrauterine intestinal volvulus was suspected. At 29\u2009weeks of gestation, preterm premature rupture of membranes occurred, and an emergency cesarean section was performed. The newborn was diagnosed in the early neonatal period with intestinal perforation. The diagnosis was postnatally confirmed by surgery and histopathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The type of fetal intervention and late gestational age of the procedure increase the risk of complications. This case alerts health providers to be vigilant in the follow-up of patients with complicated monochorionic pregnancies.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13256-020-02444-3","type":"journal-article","created":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T00:02:49Z","timestamp":1596844969000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Intestinal volvulus in the pump twin of a twin reversed arterial perfusion (TRAP) sequence after laser therapy at 18\u2009weeks: a case report"],"prefix":"10.1186","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3603-1103","authenticated-orcid":false,"given":"Tania T.","family":"Herrera","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katia","family":"Rueda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Honorina","family":"Espinosa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle B.","family":"Britton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,8,8]]},"reference":[{"key":"2444_CR1","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1002\/uog.15821","volume":"47","author":"A Khalil","year":"2016","unstructured":"Khalil A, Rodgers M, Baschat A, Bhide A, Gratacos E, Hecher K, Kilby MD, Lewi L, Nicolaides KH, Oepkes D, Raine-Fenning N, Reed K, Salomon LJ, Sotiriadis A, Thilaganathan B, Ville Y. ISUOG practice guidelines: role of ultrasound in twin pregnancy. Ultrasound Obstet Gynecol. 2016;47:247\u201363.","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2444_CR2","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1002\/uog.12495","volume":"42","author":"G Pagani","year":"2013","unstructured":"Pagani G, D\u2019Antonio F, Khalil A, et al. Intrafetal laser treatment for twin reversed arterial perfusion sequence: cohort study and meta-analysis. Ultrasound Obstet Gynecol. 2013;42:6\u201314.","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2444_CR3","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1002\/uog.12578","volume":"43","author":"C Berg","year":"2014","unstructured":"Berg C, Holst D, Mallmann MR, Gottschalk I, Gembruch U, Geipel A. Early vs late intervention in twin reversed arterial perfusion sequence. Ultrasound Obstet Gynecol. 2014;43:60\u20134.","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"Suppl 1","key":"2444_CR4","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1002\/uog.8627","volume":"36","author":"K Fuchs","year":"2010","unstructured":"Fuchs K, Van der Veer A, Miller R, Simpson L. Fetal skeletal malformations among pump twins in monochorionic gestations complicated by TRAP sequence [abstract]. Ultrasound Obstet Gynecol. 2010;36(Suppl 1):258\u20139.","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2444_CR5","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1002\/jcu.20296","volume":"35","author":"CY Chen","year":"2007","unstructured":"Chen CY, Wu YC, Chen CL, Yang ML. Acardiac syndrome coexisting with complex skeletal dysplasia in the co-twin: 3D sonographic findings. J Clin Ultrasound. 2007;35:387\u20139.","journal-title":"J Clin Ultrasound"},{"key":"2444_CR6","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1097\/00019605-200501000-00011","volume":"14","author":"OA Habbal","year":"2005","unstructured":"Habbal OA, Kenue RK, Venugopalan P. Acardia syndrome coexisting with gastroschisis in the co-twin. Clin Dysmorphol. 2005;14:45\u20137.","journal-title":"Clin Dysmorphol"},{"key":"2444_CR7","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1186\/1752-1947-4-411","volume":"4","author":"S Athwal","year":"2010","unstructured":"Athwal S, Millard K, Lakhoo K. Twin reversed arterial perfusion (TRAP) sequence in association with VACTERL association: a case report. J Med Case Rep. 2010;4:411.","journal-title":"J Med Case Rep"},{"key":"2444_CR8","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1055\/s-0033-1349367","volume":"3","author":"E Ohuoba","year":"2013","unstructured":"Ohuoba E, Fruhman G, Olutoye O, Zacharias N. Perinatal survival of a fetus with intestinal volvulus and intussusception: a case report and review of the literature. AJP Rep. 2013;3:107\u201312.","journal-title":"AJP Rep"},{"key":"2444_CR9","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1046\/j.1469-0705.1999.13030200.x","volume":"13","author":"SJ Yoo","year":"1999","unstructured":"Yoo SJ, Park KW, Cho SY, Sim JS, Hhan KS. Definitive diagnosis of intestinal volvulus in utero. Ultrasound Obstet Gynecol. 1999;13:200\u20133.","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"4","key":"2444_CR10","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1002\/jcu.21896","volume":"41","author":"W Yu","year":"2013","unstructured":"Yu W, Ailu C, Bing W. Sonographic diagnosis of fetal intestinal volvulus with ileal atresia: a case report. J Clin Ultrasound. 2013;41(4):255\u20137.","journal-title":"J Clin Ultrasound"},{"key":"2444_CR11","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1016\/S0140-6736(03)14237-7","volume":"362","author":"JG Hall","year":"2003","unstructured":"Hall JG. Twinning. Lancet. 2003;362:735\u201343.","journal-title":"Lancet"},{"key":"2444_CR12","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1002\/uog.3816","volume":"28","author":"K Hecher","year":"2006","unstructured":"Hecher K, Lewi L, Gratacos E, Huber A, Ville Y, Deprest J. Twin reversed arterial perfusion: fetoscopic laser coagulation of placental anastomoses or the umbilical cord. Ultrasound Obstet Gynecol. 2006;28:688\u201391.","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"6","key":"2444_CR13","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1515\/jpm-2015-0165","volume":"44","author":"F Mone","year":"2016","unstructured":"Mone F, Devaseelan P, Ong S. Intervention versus a conservative approach in the management of TRAP sequence: a systematic review. J Perinat Med. 2016;44(6):619\u201329.","journal-title":"J Perinat Med"},{"key":"2444_CR14","doi-asserted-by":"publisher","first-page":"1322","DOI":"10.3109\/14767058.2015.1047336","volume":"29","author":"A Sciarrone","year":"2016","unstructured":"Sciarrone A, Terruzi E, Pertusio A, Bastonero S, Errante G, Todros T, Viora E. Fetal midgut volvulus: report of eight cases. J Matern Fetal Neonatal Med. 2016;29:1322\u20137.","journal-title":"J Matern Fetal Neonatal Med"},{"key":"2444_CR15","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1046\/j.1469-0705.2001.00425.x","volume":"18","author":"B Uerpairrojkit","year":"2001","unstructured":"Uerpairrojkit B, Charoenvidhya D, Tanawattanacharoen S, Manotaya S, Wacharaprechanont T, Tannirandorn Y. Fetal intestinal volvulus: a clinico-sonographic finding. Ultrasound Obstet Gynecol. 2001;18:186\u20137.","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2444_CR16","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1002\/pd.5392","volume":"39","author":"C Bartholmot","year":"2019","unstructured":"Bartholmot C, Faure JM, Grosjean F, et al. Prenatal diagnosis of antenatal midgut volvulus: specific ultrasound features. Prenat Diagn. 2019;39:16\u201325.","journal-title":"Prenat Diagn"},{"key":"2444_CR17","doi-asserted-by":"publisher","first-page":"1326","DOI":"10.1111\/jog.12720","volume":"41","author":"M Takano","year":"2005","unstructured":"Takano M, Murata S, Fujiwara M, Hirata H, Nakata M. Experience of fetoscopic laser photocoagulation and cord transection for twin-reversed arterial perfusion sequence. J Obstet Gynaecol Res. 2005;41:1326\u20139.","journal-title":"J Obstet Gynaecol Res"},{"key":"2444_CR18","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1111\/jog.13600","volume":"44","author":"H Sago","year":"2018","unstructured":"Sago H, Ishii K, Sugibayashi R, Ozawa K, Sumie M, Wada S. Fetoscopic laser photocoagulation for twin-twin transfusion syndrome. J Obstet Gynaecol Res. 2018;44:831\u20139.","journal-title":"J Obstet Gynaecol Res"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-020-02444-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-020-02444-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-020-02444-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T12:51:40Z","timestamp":1696510300000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-020-02444-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,8]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["2444"],"URL":"https:\/\/doi.org\/10.1186\/s13256-020-02444-3","relation":{},"ISSN":["1752-1947"],"issn-type":[{"type":"electronic","value":"1752-1947"}],"subject":[],"published":{"date-parts":[[2020,8,8]]},"assertion":[{"value":"28 November 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 June 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 August 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Informed consent was obtained.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"We have no conflicts of interest to declare.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"123"}}