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Twin anemia-polycythemia sequence in a case of monoamniotic twins.

Authors :
Diehl W
Glosemeyer P
Tavares De Sousa M
Hollwitz B
Ortmeyer G
Hecher K
Source :
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology [Ultrasound Obstet Gynecol] 2013 Jul; Vol. 42 (1), pp. 108-11. Date of Electronic Publication: 2013 Jun 06.
Publication Year :
2013

Abstract

Twin anemia-polycythemia sequence (TAPS) complicates up to 6% of monochorionic diamniotic twin pregnancies, typically in the late second or third trimester. The presence of only a few and very small arteriovenous vascular anastomoses characterizes the underlying angioarchitecture at the chorionic plate in cases of TAPS. In monoamniotic twins, large vascular anastomoses can usually be seen at the placental vascular equator, and therefore one would not expect the development of TAPS in monoamniotic twins. We report a case of TAPS in a monoamniotic pregnancy at 26 + 5 weeks' gestation which responded favorably to fetoscopic laser coagulation of the small placental anastomoses, resolving severe anemia in one twin and polycythemia in the other. The pregnancy continued until 32 + 5 weeks, when worsening cord entanglement with increased resistance and the development of postsystolic notches in the umbilical artery of one twin prompted delivery by Cesarean section. There was only a moderate difference in neonatal hemoglobin concentrations, with the former polycythemic twin needing a single partial volume exchange transfusion. The postnatal course of the neonates was uneventful, according to their gestational age at birth. To our knowledge this is the first case report describing successful laser therapy for TAPS in monoamniotic twins.<br /> (Copyright © 2013 ISUOG. Published by John Wiley & Sons, Ltd.)

Details

Language :
English
ISSN :
1469-0705
Volume :
42
Issue :
1
Database :
MEDLINE
Journal :
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
Publication Type :
Academic Journal
Accession number :
23361996
Full Text :
https://doi.org/10.1002/uog.12418