Abstract:

Objective: To analyze the characteristics of prenatal ultrasound in twin reversed arterial perfusion sequence (TRAPS). Methods: Retrospective analysis was conducted on the ultrasound characteristics of 22 cases of the TRAPS diagnosed in Northwest Women and Children′s Hospital from January 2015 to October 2020. Results: ①There were 13 cases with no heart and no head, no upper limbs, only part of the spine and lower limbs; 5 cases with head but no heart. The halo of skull or part of skull, limbs and spine could be seen, and no heart structure was found. The intracranial structure of these 5 cases was not clear or only part of brain tissue could be seen, or there were serious intracranial malformations; 4 cases of unformed centerlessness showed mass echo of irregular tissue without body structure. ②Concomitant deformity of centerlessness: 13 cases were accompanied with systemic edema, including 4 cases of lymphangioma, 1 case of whole forebrain, 1 case of forebrain with omphalocele, and 2 cases of hydrocephalus. ③In those pump twins, all of 22 cases were found fetal heart by ultrasound. One case showed NT thickening, double lung echo enhancement, intracardiac structural disorder, cardiothoracic ratio increase, pleural effusion, single umbilical artery, and no obvious abnormality was found in other fetuses. ④Color Doppler showed that those fetuses without cardiac malformation had the umbilical artery blood flow and reverse into the abdominal cavity. Conclusions: Prenatal ultrasound is an important means of TRAPS diagnosis. The early diagnosis of TRAPS is helpful to determine the prognosis and provide reliable reference for the treatment.

Key words: Ultrasonography, prenatal, Congenital abnormalities, Diseases in twins, Ultrasonography, Doppler, color, Prenatal diagnosis