Open AccessTwin Anemia-Polycythemia Sequence: Diagnostic Criteria, Classification, Perinatal Management and Outcome
Author(s) -
Femke Slaghekke,
Willem J. Kist,
Dick Oepkes,
S.A. Pasman,
Jaap M. Middeldorp,
Frans J.C.M. Klumper,
Frans J. Walther,
Frank P.H.A. Vandenbussche,
Enrico Lopriore
Publication year - 2010
Publication title -
fetal diagnosis and therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.976
H-Index - 60
eISSN - 1421-9964
pISSN - 1015-3837
DOI - 10.1159/000304512
Subject(s) - monochorionic twins , medicine , amniotic fluid , twin to twin transfusion syndrome , anastomosis , fetus , anemia , obstetrics , fetoscopy , prenatal diagnosis , pregnancy , pediatrics , surgery , genetics , biology
Monochorionic twins share a single placenta with intertwin vascular anastomoses, allowing the transfer of blood from one fetus to the other and vice versa. These anastomoses are the essential anatomical substrate for the development of several complications, including twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS). TTTS and TAPS are both chronic forms of fetofetal transfusion. TTTS is characterized by the twin oligopolyhydramnios sequence, whereas TAPS is characterized by large intertwin hemoglobin differences in the absence of amniotic fluid discordances. TAPS may occur spontaneously in up to 5% of monochorionic twins and may also develop after incomplete laser treatment in TTTS cases. This review focuses on the pathogenesis, incidence, diagnostic criteria, management options and outcome in TAPS. In addition, we propose a classification system for antenatal and postnatal TAPS.
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