VP22.07: Twin reversed arterial perfusion sequence: a case report
Bibliographic record
Abstract
Twin reversed arterial perfusion (TRAP) sequence is an extremely rare congenital anomaly. With the rate of 1/35,000 births, this sequence occurs only inmonochorionic twins (MCDA). This condition is characterised by a malformed fetus without cardiac activities being perfused by a structurally normal one (pumping twin) via an artery-to-artery anastomosis in a reverse direction. A 28-year-old woman, gravida 1, 26 weeks MCDA twin prenancy, diagnosed with TRAP. Ultrasonography revealed a viable pumping twin and an acardiac one who was receiving the blood. While the former appeared to be anemia (CSV-MCA = 1.6MOM) and life-threatened, the later had serious edema and no cardiac structures were observed. An emergency fetoscopic intervention was performed to coagulate the umbilical cordof acardiac twin by laser therapy. After surgery, both the woman and the remaining fetus were closely monitored and treated with steroids, antibiotics and tocolytics. A healthy 1,400g female baby was delivered at 34 weeks of gestation by Caesarean section when the membrane was ruptured. Normal karyotypwas reported. Current management options include conservative or surgical interventions. Indication of pregnancy termination depends on the condition of fetal impairment, andthe growth of the the acardiac twin. As the pumping twin appeared to be distressed, an emergency fetoscopy was our only choice. We had performed a successful surgery and kept the pregnancy up to 34 weeks with no further complications noted. In conclusion, TRAP needs to be properly diagnosed and treated early to avoid complications of pump twin. Fetoscopy is a new and effective treatment of this condition. Supporting information can be found in the online version of this abstract Supporting Information Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.060 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".