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Spontaneous twin anemia?polycythemia sequence complicated by recipient placental vascular thrombosis and hydrops fetalis.
MedLine Citation:
PMID:  20593976     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Twin anemia?polycythemia sequence (TAPS) is an atypical form of twin?twin transfusion syndrome (TTTS) that presents as a large intertwin hemoglobin difference with one twin developing anemia and the other developing polycythemia, without oligohydramnios?polyhydramnios sequence (Lopriore et al., Placenta 2007;28:47?51). The prenatal diagnostic criteria for TAPS require that the middle cerebral artery-peak systolic velocity (MCA-PSV) measure greater than 1.5 multiples of median (MoM) in the donor twin and less than 0.8 MoM in the recipient twin (Robyr et al., Am J Obstet Gynecol 2006;194:796?803; Klaritsch et al., Ultrasound Obstet Gynecol 2009;34:149?154; Mari et al., N Engl Med 2000;342:9?14). The presumed etiology of TAPS involves the presence of small caliber arteriovenous anastomoses, which generate a slow transfusional process allowing for hemodynamic compensation (Lopriore et al., Placenta 2007;28:47?51; Lopriore et al., Placenta 2009;30:223?225; Lewi et al., Am J Obstet Gynecol 2006;194:790?795; Lopriore et al., Am J Obstet Gynecol 2008;112:753?758; Van den Wijngaard et al., Placenta 2007;28:611?615). The resulting polycythemia in the recipient twin is a risk factor for fetal and placental thrombosis (Van den Wijngaard et al., Am J Physiol 2005;288:R799?R814). We present a case of spontaneous TAPS complicated by a large placental vessel thrombosis and hydrops fetalis. Treatment via selective laser photocoagulation of communicating vessels (SLPCV) resulted in normalization of the MCA-PSV discordance.
Authors:
Samer A Assaf; Kurt Benirschke; Ramen H Chmait
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Publication Detail:
Type:  Journal Article     Date:  2010-07-01
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  24     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  549-52     Citation Subset:  IM    
Affiliation:
Division of Maternal?Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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