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Fetal intraperitoneal transfusion for iatrogenic twin anemia–polycythemia sequence after laser therapy
Author(s) -
Herway C.,
Johnson A.,
Moise K.,
Moise K. J.
Publication year - 2009
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.6334
Subject(s) - medicine , polyhydramnios , oligohydramnios , anemia , anastomosis , surgery , laser coagulation , laser surgery , pregnancy , fetus , obstetrics , laser , genetics , physics , visual acuity , optics , biology
Twin anemia–polycythemia sequence (TAPS) is a rare variant of twin–twin transfusion syndrome (TTTS) without the characteristic twin oligohydramnios–polyhydramnios sequence and cardiovascular milieu attributed to renin–angiotensin system mediators. It can occur spontaneously or iatrogenically after fetoscopic laser surgery. We report the case of a woman, gravida 2 para 1, with a monochorionic diamniotic pregnancy who developed Quintero Stage III TTTS. She underwent laser photocoagulation of identifiable anastomotic vessels and subsequently developed suspected TAPS 2 weeks later. The pregnancy was successfully treated with serial intrauterine intraperitoneal transfusions (IUT‐PTs) of red blood cells. Although TAPS is a rare condition, serial middle cerebral artery peak systolic velocity measurements are warranted as follow‐up in patients who have undergone fetoscopic laser surgery for TTTS. IUT‐PTs may be superior to intravascular intrauterine transfusions in the treatment of this condition. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.