EP10.18: Fetal therapy for twin reverse arterial perfusion sequence: experience from two centres in Chile

To describe perinatal outcomes of twin reverse arterial perfusion (TRAP) sequence who underwent fetal therapy in two centres of Chile. Descriptive analysis of a cohort of fetal therapy for TRAP sequence between 2010 and 2023 at Hospital Clínico de la Universidad de Chile or Hospital Clínico San Borja-Arriarán. 16 cases were identified. Outcomes were unavailable for 2 cases. Among the 14 cases with complete results, 3 were managed using bipolar coagulation (BPC) and 11 underwent intrapelvic laser (IPL) therapy. The average gestational age (GA) for therapy was 19+3 weeks (range 13+5 – 25+2). There were 3 reinterventions, all in the IPL group: one second IPL and two early intrauterine transfusions. There was 9 of 14 (64.2%) live newborns (NB). The average GA at birth for live NB was 37+0 weeks (range 34+0-40+3), with 6 term deliveries. Based on the type of therapy, 3 out of 3 treated with BPC survived, while 6 out of 11 treated with IPL survived. No maternal complications were reported. Pregnancies complicated by TRAP sequence are associated with high rates of prenatal morbidity and mortality. Early diagnosis allows for timely intervention to protect the pump twin.