<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412019000600368</article-id>
<article-id pub-id-type="doi">10.24245/gom.v87i6.2871</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Secuencia TRAP: serie de casos en el Hospital Regional de Alta Especialidad de la Mujer de Tabasco]]></article-title>
<article-title xml:lang="en"><![CDATA[TRAP sequence: Series of cases in Hospital Regional de Alta Especialidad de la Mujer de Tabasco]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González-González]]></surname>
<given-names><![CDATA[Diego Arturo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fierros-Adame]]></surname>
<given-names><![CDATA[May Milena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Regional de Alta Especialidad de la Mujer de Tabasco  ]]></institution>
<addr-line><![CDATA[Villa Hermosa Tabasco]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Regional de Alta Especialidad de la Mujer de Tabasco servicio de Medicina Materno Fetal ]]></institution>
<addr-line><![CDATA[Villa Hermosa Tabasco]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2019</year>
</pub-date>
<volume>87</volume>
<numero>6</numero>
<fpage>368</fpage>
<lpage>378</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412019000600368&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412019000600368&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412019000600368&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  OBJETIVO: Reportar, comparar y analizar el estado posnatal de pacientes con embarazo gemelar monocorial y determinar la incidencia de secuencia TRAP.  MATERIALES Y MÉTODOS: Estudio retrospectivo y descriptivo de una serie de casos de pacientes con diagnóstico de embarazo múltiple monocorial atendidas entre 2014 y 2018 en el Hospital Regional de Alta Especialidad de la Mujer de Tabasco. Se incluyeron todas las pacientes con diagnóstico de secuencia de perfusión arterial reversa gemelar con finalización del embarazo y reporte del estado posnatal. Se determinó la incidencia y se excluyeron las pacientes con expedientes incompletos y embarazos no concluidos en el Hospital Regional.  RESULTADOS: Se encontraron 6 casos de embarazo gemelar monocorial con secuencia TRAP. De los casos reportados, 5 fueron gemelar doble y 1 de alto orden fetal. Solo 1 de los 6 casos recibió tratamiento intraútero. En 4 casos el gemelo bomba supervivió sin complicaciones reportadas. La incidencia de secuencia TRAP de embarazos monocoriales de la muestra de estudio fue de 5.2%.  CONCLUSIÓN: Se expusieron 6 casos tratados de diferentes maneras y con mejores resultados con la conducta conservadora porque en los 4 casos que no recibieron tratamiento los gemelos bomba no sufrieron descompensaciones cardiacas y supervivieron, a diferencia del único caso con tratamiento intra-útero en el que hubo complicaciones que llevaron a la terminación del embarazo en el segundo trimestre.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  OBJECTIVE: Report, compare and analyze the postnatal status of patients with monochorionic twin pregnancy and determine the incidence of TRAP sequence.  MATERIALS AND METHODS: A descriptive, retrospective, case series study of patients diagnosed with monochorionic multiple pregnancy attended at the High Specialty Regional Women&#8217;s Hospital of Tabasco between 2014 and 2018 was carried out. The study included all patients with the diagnosis of TRAP sequence, reported postnatal outcomes and the incidence was determined. Patients with incomplete records and unfinished pregnancies were excluded.  RESULTS:  Six cases of twin reversed arterial perfusion were diagnosed, five of which were twin pregnancies and one was a higher order multiple pregnancy. Only one of the patients received intra-uterine treatment. The pump twin survived without complications in four of the six cases.  CONCLUSION: Six treated cases were exposed in different ways and with better results with the conservative behavior because in the 4 cases that did not receive treatment, the twin pump did not suffer cardiac decompensation and survived, unlike the only case with intra-uterine treatment in which there were complications that led to termination of pregnancy in the second trimester.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Embarazo múltiple monocorial]]></kwd>
<kwd lng="es"><![CDATA[secuencia TRAP]]></kwd>
<kwd lng="es"><![CDATA[transfusión feto-fetal]]></kwd>
<kwd lng="es"><![CDATA[segundo trimestre del embarazo]]></kwd>
<kwd lng="es"><![CDATA[defectos cardiacos, congénitos]]></kwd>
<kwd lng="en"><![CDATA[Monochorionic twin pregnancy]]></kwd>
<kwd lng="en"><![CDATA[TRAP sequence]]></kwd>
<kwd lng="en"><![CDATA[Fetofetal transfusion]]></kwd>
<kwd lng="en"><![CDATA[Pregnancy Trimester, Second]]></kwd>
<kwd lng="en"><![CDATA[Heart defects, congenital]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gillim]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
<name>
<surname><![CDATA[Hendricks]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Holoacardius; review of the literature and case report]]></article-title>
<source><![CDATA[Obstet Gynecol]]></source>
<year>1953</year>
<volume>2</volume>
<page-range>647-53</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Van Gemert]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Twin reversed arterial perfusion sequence is more common than generally accepted]]></article-title>
<source><![CDATA[Birth Defects Research Part A: Clinical and Molecular Teratology]]></source>
<year>2015</year>
<volume>103</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>641-3</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acardiac Twinning (Twin reversed arterial perfusion sequence): a review of prenatal management]]></article-title>
<source><![CDATA[Taiw J Obstet Gynecol]]></source>
<year>2005</year>
<volume>44</volume>
<page-range>105-15</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Van Allen]]></surname>
<given-names><![CDATA[MI]]></given-names>
</name>
<name>
<surname><![CDATA[Smith]]></surname>
<given-names><![CDATA[DW]]></given-names>
</name>
<name>
<surname><![CDATA[Shepard]]></surname>
<given-names><![CDATA[TH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Twin reversed arterial perfusion (TRAP) sequence: a study of 14 twin pregnancies with acardius]]></article-title>
<source><![CDATA[Semin Perinatol]]></source>
<year>1983</year>
<volume>7</volume>
<page-range>285-93</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ruiz-Cordero]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Twin Reversed Arterial Perfusion Sequence (TRAPS): An Illustrative Series of 13 Cases]]></article-title>
<source><![CDATA[Fetal Pediatr Pathol]]></source>
<year>2016</year>
<volume>35</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>63-80</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sepulveda]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acardiac twin: too many invasive treatment options - the problem and not the solution]]></article-title>
<source><![CDATA[Ultrasound Obstet Gynecol]]></source>
<year>2004</year>
<volume>24</volume>
<page-range>387-9</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martimucci]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Use of the Tei Index in the Conservative Management of TRAP Sequence Pregnancies Diagnosed during the Periviable Period]]></article-title>
<source><![CDATA[A Case Series Case Rep Obstet Gynecol]]></source>
<year>2018</year>
<page-range>2521797</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moore]]></surname>
<given-names><![CDATA[TR]]></given-names>
</name>
<name>
<surname><![CDATA[Gale]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Benirschke]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Perinatal outcome of forty-nine pregnancies complicated by acardiac twinning]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>1990</year>
<volume>163</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>907-12</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mone]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Intervention versus a conservative approach in the management of TRAP sequence: a systematic review]]></article-title>
<source><![CDATA[J Per Med]]></source>
<year>2015</year>
<volume>44</volume>
<page-range>619-29</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wagata]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Radiofrequency Ablation with an Internally Cooled Electrode for Twin Reversed Arterial Perfusion Sequence]]></article-title>
<source><![CDATA[Fetal Diagn Ther]]></source>
<year>2016</year>
<volume>40</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>110-5</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ventura-Laveriano]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fetoscopia y coagulación bipolar selectiva en una gestación gemelar complicada con secuencia arterial reversa. A propósito del primer caso en el Perú]]></article-title>
<source><![CDATA[Rev. peru. ginecol. obstet]]></source>
<year>2015</year>
<volume>61</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>41-4</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jelin]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Perinatal outcome of conservative management versus fetal intervention for twin reversed arterial perfusion sequence with a small acardiac twin]]></article-title>
<source><![CDATA[Fetal Diagn Ther]]></source>
<year>2010</year>
<volume>27</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>138-41</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cabassa]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The use of radiofrequency in the treatment of twin reversed arterial perfusion sequence: a case series and review of the literatura]]></article-title>
<source><![CDATA[Eur J Obstet Gynecol Reprod Biol]]></source>
<year>2013</year>
<volume>166</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>127-32</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hirose]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Successful intrauterine treatment with radiofrequency ablation in a case of acardiac twin pregnancy complicated with a hydropic pump twin]]></article-title>
<source><![CDATA[Ultrasound Obstet Gynecol]]></source>
<year>2004</year>
<volume>23</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>509-12</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
