Abstract
Background TRAP sequence occurs in monochorionic pregnancies consisting of one normal fetus and a non-viable fetus. The pump twin has an increased risk of developing high-output cardiac failure. Case 32-year-old G4P2012 with TRAP syndrome in current pregnancy presented to triage at 26 weeks with contractions and spotting. She had undergone RFA for selective reduction at another facility. Placental abruption was suspected and patient underwent a cesarean section. Twin A was delivered alive although she subsequently succumbed due to complications of prematurity. Conclusion This case highlights the importance of early detection and consistent prenatal care in the management of TRAP sequence. Further research of interventions associated with improved outcomes should be encouraged.