High-intensity focused ultrasound treatment for twin reversed arterial perfusion sequence

K. Ichizuka, J. Hasegawa, M. Nakamura, R. Matsuoka, A. Sekizawa, T. Okai, S. Umemura

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


Twin reversed arterial perfusion (TRAP) sequence is a serious complication of monochorionic twin pregnancies, in which arterioarterial anastomoses allow blood flow from a 'pump' fetus to an acardiac fetus via reversed flow in the latter's umbilical artery. Several trial treatments for TRAP sequence have been reported, but all of these have been invasive. We present a case of TRAP sequence in which high-intensity focused ultrasound (HIFU) was applied to the umbilical artery of the anomalous twin at 26 weeks as a non-invasive fetal therapy. The HIFU intensity was set at approximately 2300 W/cm 2 with exposure periods of 10 s. Color Doppler ultrasound showed a decrease in blood supply to the anomalous twin, although complete occlusion of the targeted vessel was not achieved. Delivery was by Cesarean section at 29 weeks' gestation and the pump twin survived, without severe clinical complications at 6 months.

Original languageEnglish
Pages (from-to)476-478
Number of pages3
JournalUltrasound in Obstetrics and Gynecology
Issue number4
Publication statusPublished - 10-2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynaecology


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