Table 2 Summary of literature on TRAP syndrome and conjoined twins
PMID | Study Type | Study Design/Sample Characteristics | Key Findings and Conclusions | Support and Implications for This Study |
|---|---|---|---|---|
37,835,852 | Case Report & Review | Two MCMA twin TRAP cases; includes literature review. | Transvaginal and 3D ultrasound are critical for early diagnosis; early intervention improves outcomes. | Supports the importance of early ultrasound diagnosis in this case, emphasizing anatomical variation identification. |
35,466,064 | Review | Literature review on TRAP pathophysiology and treatments (RFA, laser). | RFA is the primary intervention, but optimal timing remains unclear; comparative studies are needed. | Provides theoretical basis for selecting RFA in this case; highlights the need for optimized timing. |
23,122,031 | Retrospective Study | 11 TRAP cases (7 underwent RFA); median intervention at 17 weeks. | RFA is safe and effective (85% neonatal survival), but optimal timing requires further research. | Supports feasibility of RFA at 18 + 5 weeks in this case, aligning with mid-gestation intervention. |
39,705,119 | Retrospective Cohort | 107 MC twins (12 TRAP cases); RFA learning curve analysis. | Increased procedural proficiency prolongs delivery intervals (2019–2023 vs. 2013–2018). | Highlights the role of multidisciplinary expertise, consistent with this case’s workflow. |
33,757,441 | Case Report | One MCDA triplet pregnancy (two acardiac twins) treated with laser at 15 weeks. | Early individualized intervention (laser) improves outcomes (healthy delivery at 37 weeks). | Suggests alternatives (e.g., laser) for complex cases, though RFA was prioritized here. |
39,626,652 | Systematic Review | 757 TRAP cases from 120 studies. | RFA has the highest technical success; prospective studies are needed to define optimal timing. | Validates RFA effectiveness in this case; aligns with the need for larger cohort studies. |
34,728,404 | Review | Literature review on MCMA complications (TRAP, conjoined twins). | Early anatomical screening and close monitoring reduce fetal loss risks. | Reinforces the 13 + 1-week diagnostic strategy and imaging’s central role in this case. |
36,123,247 | Review | Monitoring and management of MCMA twins (including TRAP and conjoined twins). | Prenatal surveillance and timely delivery improve outcomes. | Aligns with this case’s multidisciplinary monitoring and perinatal management. |
32,890,327 | Review | Early evaluation of MC twin complications (TRAP, conjoined twins). | Early ultrasound is critical for diagnosis and management. | Strengthens the rationale for early ultrasound in identifying anatomical variations. |
30,479,634 | Review | Ultrasound protocols for twin pregnancies (including TRAP and conjoined twins). | Standardized ultrasound protocols enhance complication detection. | Supports the standardized INTERGROWTH-21st protocol used in this case. |
34,540,478 | Review | Congenital heart defects (CHD) in MC twins and TRAP association. | TRAP may increase CHD risk in pump twins; fetal echocardiography is essential. | Explains the postnatal ASD in this case; underscores long-term cardiac follow-up needs. |
33,017,845 | Guidelines & Recommendations | Diagnostic and management guidelines for twin pregnancies (including TRAP). | Recommends early diagnosis, multidisciplinary collaboration, and individualized intervention. | Validates the multidisciplinary approach and framework used in this case. |
20,069,540 | Review | Umbilical cord entanglement in 32 monoamniotic twins. | Close monitoring after 20 weeks improves outcomes despite cord entanglement. | Supports the safety of mid-gestation intervention in this case. |
24,355,992 | Review | Early ultrasound for chorionicity determination and twin management. | Early ultrasound improves complication identification and management. | Reinforces the timeliness of diagnosis at 13 + 1 weeks in this case. |
16,284,762 | Review | MRI and ultrasound in complex twin pregnancies (32 cases). | MRI complements ultrasound for assessing conjoined structures and hemodynamics. | Highlights the limitation of missing MRI data in this case; suggests multimodal imaging for future studies. |
11,093,987 | Case Series | Fetoscopic surgery for TRAP/TTTS in three cases (anesthetic management). | Anesthetic strategies must balance maternal-fetal safety; individualized decisions are key. | Indirectly supports the local anesthesia strategy and multidisciplinary collaboration in this case. |