Twin anemia polycythemia sequence from a prenatal perspective

Léonardo Gucciardo, Liesbeth Lewi, Pascal Vaast, Marzena Debska, Luc De Catte, Tim Van Mieghem, Elisa Done, Roland Devlieger, Jan Deprest

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

OBJECTIVES: To describe the prevalence, management and outcome of spontaneous twin anemia polycythemia sequence (TAPS) diagnosed in the prenatal period.

METHOD: Retrospective analysis of 142 consecutive monochorionic twin pregnancies not diagnosed with twin to twin transfusion syndrome. TAPS cases were identified based on the presence of discordant middle cerebral artery peak systolic velocity (MCA-PSV) measurements and signs suggestive of a chronic intertwin transfusion imbalance: either an elevated reticulocyte count in the anemic twin or the presence of few small unidirectional anastomoses during fetoscopy or at postnatal placental examination.

RESULTS: Three cases were identified, giving an estimated prevalence of 2%. Prenatal interventions were tailored to the characteristics of each case and consisted of intrauterine transfusion and interruption of the shared circulation by cord coagulation or laser separation.

CONCLUSION: In monochorionic twin pregnancies, TAPS is an uncommon prenatal finding. Nonetheless, its incidence seems high enough to recommend screening for this disease by MCA-PSV measurements.

Original languageEnglish
Pages (from-to)438-442
Number of pages5
JournalPrenatal Diagnosis
Volume30
Issue number5
DOIs
Publication statusPublished - 2010

Keywords

  • Adult
  • Anemia, Neonatal
  • Arteriovenous Anastomosis
  • Belgium
  • Blood Transfusion, Intrauterine
  • Diseases in Twins
  • Female
  • Humans
  • Infant, Newborn
  • Laser Coagulation
  • Middle Cerebral Artery
  • Oligohydramnios
  • Placenta Diseases
  • Polycythemia
  • Pregnancy
  • Prevalence
  • Rheology
  • Syndrome
  • Ultrasonography, Prenatal

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