World TRAP Awareness Day Date in the current year: December 10, 2024

Twin-to-twin transfusion syndrome (TTTS) is a complication of a twin pregnancy where the twins share a single placenta (monochorionic pregnancy) characterized by disproportionate blood supply between the fetuses. In addition to the classic form of TTTS, there are several variants of the syndrome: twin anemia polycythemia sequence (TAPS), selective intrauterine growth restriction (SIUGR or sIUGR), and twin reversed arterial perfusion sequence (TRAP sequence or TRAPS).

TRAP sequence is a rare and severe variant of TTTS where the blood systems of the twins are connected instead of independent and one twin fails to properly develop a heart. The fetus lacking a heart is called the acardiac twin, and the “normal” fetus is called the pump twin because it drives blood through both fetuses through their shared blood system.

The acradiac twin is severely malformed and may lack body parts and internal organs; some TRAP fetuses are just a mass of tissue with blood vessels. The pump twin usually develops normally in the womb, although it is usually smaller than normal for its gestational age. Due to the increased pumping of the heart, the pump twin is at risk for cardiac failure. The bigger the acardiac twin, the higher the risk for the pump twin.

TRAP is usually suspected during a prenatal ultrasound examination. To confirm the diagnosis, a Doppler ultrasound test is required. If it is determined that the pump twin is at a high risk of death from heart failure, fetal surgery may be recommended to stop the abnormal blood flow between the fetuses. Depending on the gestational age and other factors, the doctor may recommend radiofrequency ablation or bipolar coagulation.

World TRAP Awareness Day is one of four awareness days observed during World TTTS Awareness Month, alongside World TTTS Awareness Day, World TAPS Awareness Day and World SIUGR Awareness Day, observed on December 7, 8, and 9, respectively. It was created by the The Twin to Twin Transfusion Syndrome Foundation (TTTS Foundation).

The TTTS Foundation was established by Mary Salman who lost one of her twins to TTTS in 1989 and took a pledge to make sure her babies would be known and remembered. Salman coined the term “daisy babies” for babies who have survived TTTS, established the TTTS Foundation, and created awareness days to raise awareness of TTTS and its forms.

The main goals of World TRAP Day are to increase awareness of TRAP sequence among both healthcare professionals and the general public, encourage research into TRAP, and provide help and support to families affected by the syndrome. You can join the campaign and shine a light on TRAP by posting on social media with the hashtags #WorldTRAPDay and #WorldTRAPAwarenessDay.