Document Detail


Twin anemia polycythemia sequence (TAPS) in monoamniotic twins: a case report.
MedLine Citation:
PMID:  23361996     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Twin anemia polycythemia sequence (TAPS) complicates up to 6 % of monochorionic (MC) diamniotic twin pregnancies typically in the late second or third trimester. Few and very small arterio-venous (AV) vascular anastomoses are the underlying angioarchitecture at the chorionic plate related to TAPS. However, in monoamniotic (MA) twins usually thick vascular anastomoses can 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 (MA) pregnancy at 26+5 weeks which favorably responded to fetoscopic laser coagulation of the small placental anastomoses, resolving both, severe anemia in one twin and polycythemia in the other one. The pregnancy could be prolonged until 32+5 weeks, when tightening cord entanglement with increasing umbilical resistance and umbilical post-systolic notches in one of the twins, indicated the need for delivery by cesarean section. There was only a moderate difference in neonatal hemoglobin concentrations, with the former polyglobulic twin needing a single partial volume exchange transfusion. Furthermore, the postnatal course of the babies 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.
Authors:
Werner Diehl; Peter Glosemeyer; Manuela Tavares De Sousa; Bettina Hollwitz; Gerd Ortmeyer; Kurt Hecher
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-29
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Department Of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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