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Twin anemia polycythemia sequence

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https://www.readbyqxmd.com/read/27896259/prenatal-diagnosis-of-spontaneous-twin-anemia-polycythemia-sequence-and-postnatal-examination-of-placental-vascular-anastomoses
#1
Jin Young Bae, Jin Ju Oh, Seong Yeon Hong
Twin anemia-polycythemia sequence (TAPS) is characterized by a wide discrepancy of hemoglobin between two monochorionic fetuses without sign of twin oligo-polyhydramnios sequence. A primiparous woman with monochorionic diamniotic twin transferred for preterm labor. Ultrasonographic evaluation at 32+3 weeks of gestation revealed increased middle cerebral artery-peak systolic velocity (77.4 cm/sec, 1.69 multiples of median) in donor and decreased in recipient twin (36.4 cm/sec, 0.79 multiples of median), the twin was diagnosed with TAPS...
November 2016: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/27734505/amniotic-fluid-discordance-in-monochorionic-diamniotic-twin-pregnancies-is-associated-with-increased-risk-for-twin-anemia-polycythemia-sequence
#2
Liran Hiersch, Mayan Eitan, Eran Ashwal, Boaz Weisz, Benny Chayen, Shlomo Lipitz, Yoav Yinon
OBJECTIVE: To estimate the risk for twin anemia-polycythemia sequence (TAPS) and adverse perinatal outcome in monochorionic diamniotic (MCDA) twin pregnancies with amniotic fluid discordance (AFD). METHODS: Retrospective cohort study of 34 MCDA pregnancies with AFD (intertwin difference of ≥3 cm in maximal vertical pocket measurement) without meeting the criteria for twin to twin transfusion syndrome (TTTS) or selective intrauterine growth restriction (sIUGR)...
October 12, 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/27597647/twin-anemia-polycythemia-sequence-a-single-center-experience-and-literature-review
#3
REVIEW
Amirhossein Moaddab, Ahmed A Nassr, Jimmy Espinoza, Rodrigo Ruano, Zhoobin H Bateni, Amir A Shamshirsaz, George T Mandy, Stephen E Welty, Hadi Erfani, Edwina J Popek, Michael A Belfort, Alireza A Shamshirsaz
Twin anemia polycythemia sequence (TAPS) is defined by significant intertwin hemoglobin discordance without the amniotic fluid discordance that characterizes twin-twin-transfusion syndrome (TTTS) in monochorionic twin pregnancies. TAPS is an uncommon condition which can either occur spontaneously, or following fetoscopic laser ablation for TTTS. This complication is thought to result from chronic transfusion through very small placental anastomoses; however, the pathogenesis of TAPS remains unknown. Consequently, there is no consensus in the management of TAPS...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27549671/erythroblastosis-of-the-donor-twin-of-twin-anemia-polycythemia-sequence
#4
Miharu Takeuchi, Hidehiko Maruyama, Naoko Oura, Akane Kanazawa, Yusei Nakata, Susumu Minami, Kiyoshi Kikkawa
Twin anemia-polycythemia sequence (TAPS) is a group of disorders in monochorionic twins characterized by a large intertwin hemoglobin difference without amniotic fluid discordance. Reticulocyte count is used to diagnose this condition, but little is known about the role of erythroblasts, which are the prior stage of reticulocytes. In the present case of TAPS, the 25-yr-old Japanese mother showed no signs of oligohydramnios or polyhydramnios throughout gestation. The twins were born at 36 weeks and 6 days, weighing 2,648g and 1,994g...
August 2016: Acta Medica Okayama
https://www.readbyqxmd.com/read/27322562/antenatal-management-of-twin-twin-transfusion-syndrome-and-twin-anemia-polycythemia-sequence
#5
Femke Slaghekke, Depeng P Zhao, Johanna M Middeldorp, Frans J Klumper, Monique C Haak, Dick Oepkes, Enrico Lopriore
INTRODUCTION: Twin-twin transfusion syndrome (TTTS) and twin anemia polycythemia sequence (TAPS) are severe complications in monochorionic twin pregnancies associated with high mortality and morbidity risk if left untreated. Both diseases result from imbalanced inter-twin blood transfusion through placental vascular anastomoses. AREAS COVERED: This review focuses on the differences in antenatal management between TTTS and TAPS. Expert commentary: The optimal management for TTTS is fetoscopic laser coagulation of the vascular anastomoses, preferably using the Solomon technique in which the whole vascular equator is coagulated...
August 2016: Expert Review of Hematology
https://www.readbyqxmd.com/read/27257402/perinatal-outcomes-of-monochorionic-diamniotic-twin-pregnancies-uncomplicated-at-28-weeks-of-gestation
#6
Shunji Suzuki
We examined the prevalence of specific perinatal complications of monochorionic-diamniotic twin pregnancies in cases without any abnormal findings until the second trimester of pregnancy. This was a retrospective cohort study performed at a tertiary perinatal center in Tokyo, Japan. There were 88 cases of uncomplicated monochorionic-diamniotic twin pregnancies at 28 weeks of gestation. In five of them (5.7%), there were serious complications associated with placental circulatory imbalance between the twins during the third trimester of pregnancy...
2016: Japanese Clinical Medicine
https://www.readbyqxmd.com/read/27203607/solomon-technique-versus-selective-coagulation-for-twin-twin-transfusion-syndrome
#7
Femke Slaghekke, Dick Oepkes
Monochorionic twin pregnancies can be complicated by twin-to-twin transfusion syndrome (TTTS). The best treatment option for TTTS is fetoscopic laser coagulation of the vascular anastomoses between donor and recipient. After laser therapy, up to 33% residual anastomoses were seen. These residual anastomoses can cause twin anemia polycythemia sequence (TAPS) and recurrent TTTS. In order to reduce the number of residual anastomoses and their complications, a new technique, the Solomon technique, where the whole vascular equator will be coagulated, was introduced...
June 2016: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
https://www.readbyqxmd.com/read/27098457/the-placenta-in-twin-to-twin-transfusion-syndrome-and-twin-anemia-polycythemia-sequence
#8
Isabel Couck, Liesbeth Lewi
Twin-to-twin transfusion syndrome (TTTS) and twin anemia polycythemia sequence (TAPS) are complications unique to monochorionic twin pregnancies and their shared circulation. Both are the result of the transfusion imbalance in the intertwin circulation. TTTS is characterized by an amniotic fluid discordance, whereas in TAPS, there is a severe discordance in hemoglobin levels. The article gives an overview of the typical features of TTTS and TAPS placentas.
June 2016: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
https://www.readbyqxmd.com/read/27068823/comparison-between-monochorionic-and-dichorionic-placentas-with-special-attention-to-vascular-anastomoses-and-placental-share
#9
Depeng Zhao, Michal Lipa, Miroslaw Wielgos, Danielle Cohen, Johanna M Middeldorp, Dick Oepkes, Enrico Lopriore
Placental vascular anastomoses in twins lead to a shared circulation and may subsequently enable the development of severe complications such as twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS). The presence of vascular anastomoses has frequently and systematically been studied in monochorionic (MC) placentas, but only rarely in dichorionic (DC) placentas. The aim of this study was to compare the prevalence of vascular anastomoses and evaluate the sharing discordance in MC and DC placentas...
June 2016: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
https://www.readbyqxmd.com/read/27068715/twin-anemia-polycythemia-sequence-current-views-on-pathogenesis-diagnostic-criteria-perinatal-management-and-outcome
#10
Lisanne S A Tollenaar, Femke Slaghekke, Johanna M Middeldorp, Frans J Klumper, Monique C Haak, Dick Oepkes, Enrico Lopriore
Monochorionic twins share a single placenta and are connected with each other through vascular anastomoses. Unbalanced inter-twin blood transfusion may lead to various complications, including twin-to-twin transfusion syndrome (TTTS) and twin anemia polycythemia sequence (TAPS). TAPS was first described less than a decade ago, and the pathogenesis of TAPS results from slow blood transfusion from donor to recipient through a few minuscule vascular anastomoses. This gradually leads to anemia in the donor and polycythemia in the recipient, in the absence of twin oligo-polyhydramnios sequence (TOPS)...
June 2016: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
https://www.readbyqxmd.com/read/26996223/fetal-intra-peritoneal-transfusion-for-the-management-of-very-early-spontaneous-twin-anemia-polycythemia-sequence-in-an-obese-patient-with-a-whole-anterior-placenta
#11
Cécile Guenot, Romaine Robyr, Nicole Jastrow, Yvan Vial, Luigi Raio, David Baud
Twin anemia-polycythemia sequence (TAPS) is a rare condition in monochorionic twin pregnancies. Small intertwin placental vascular communications allow transfusion, which results in a hemoglobin difference in the twins in the absence of oligohydramnios or polyhydramnios. We report here a case of TAPS diagnosed at 17 weeks' gestation in an obese patient (BMI 42) with a whole anterior placenta. The only possible treatment at this stage of pregnancy was intra-uterine transfusion (IUT), which was repeated weekly until photocoagulation of placental anastomoses was feasible...
April 2016: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
https://www.readbyqxmd.com/read/26871537/twin-twin-transfusion-and-laser-therapy
#12
Nicholas Behrendt, Henry L Galan
PURPOSE OF REVIEW: Twin-to-twin transfusion syndrome (TTTS) is an uncommon, but dangerous, complication of monochorionic diamniotic twin gestations. The purpose of this review is to provide an update on the evolving treatments in TTTS as it pertains primarily to laser photocoagulation, as well as to provide recently published information on outcomes. RECENT FINDINGS: The Solomon laser technique, in which selective fetoscopic laser photocoagulation is first performed and then followed by laser of the vascular equator from one side of the placenta to the other, reduces TTTS complications of twin anemia-polycythemia syndrome and recurrent TTTS...
April 2016: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/26833637/re-review-of-the-correlation-between-blood-flow-velocity-and-polycythemia-in-the-fetus-neonate-and-adult-appropriate-diagnostic-levels-need-to-be-determined-for-twin-anemia-polycythemia-sequence-a-lucewicz-k-fisher-a-henry-and-a-w-welsh-ultrasound-obstet-gynecol
#13
COMMENT
https://www.readbyqxmd.com/read/26827875/atypical-twin-to-twin-transfusion-syndrome-prevalence-in%C3%A2-a%C3%A2-population%C3%A2-undergoing-fetoscopic-laser-ablation-of-communicating%C3%A2-placental-vessels
#14
Bettina Paek, Melissa Dorn, Martin Walker
BACKGROUND: The diagnosis of twin-to-twin transfusion syndrome (TTTS) usually relies the presence of polyhydramnios in one sac with concomitant oligohydramnios in the other sac in a monochorionic diamniotic twin pregnancy. However, TTTS does not always show a linear progression and may present with cardiac compromise or critically abnormal Doppler velocimetry in either fetus before fluid measurements meet the typically used cutoff. OBJECTIVE: The aim of this study was to investigate the prevalence of atypical presentations of TTTS in a population undergoing laser fetoscopy...
July 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26788848/color-difference-in-placentas-with-twin-anemia-polycythemia-sequence-an-additional-diagnostic-criterion
#15
Lisanne S A Tollenaar, Danny P Zhao, Johanna M Middeldorp, Femke Slaghekke, Dick Oepkes, Enrico Lopriore
OBJECTIVE: To determine the color intensity difference between the 2 placental shares in monochorionic placentas with twin anemia-polycythemia sequence (TAPS). METHODS: We evaluated all digital pictures of TAPS placentas examined at our center and compared them to a control group of uncomplicated monochorionic placentas. We determined the color intensity of individual placental share on the maternal side of each monochorionic placenta using an image processing program and calculated the color difference ratio (CDR)...
2016: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/26663574/can-middle-cerebral-artery-peak-systolic-velocity-predict-polycythemia-in-monochorionic-diamniotic-twins-evidence-from-a-prospective-cohort-study
#16
Michal Fishel-Bartal, Boaz Weisz, Shali Mazaki-Tovi, Eran Ashwal, Benjamin Chayen, Shlomo Lipitz, Yoav Yinon
OBJECTIVE: Antenatal diagnosis of twin anemia-polycythemia sequence (TAPS) in monochorionic diamniotic (MCDA) twin pregnancies is based on elevated peak systolic velocity in the middle cerebral artery (MCA-PSV) in the donor twin and decreased MCA-PSV in the recipient twin. However, the association between these parameters and neonatal polycythemia has not been established. The aim of this study was to determine whether MCA-PSV can predict polycythemia in MCDA pregnancies. METHODS: Prospective cohort study of MCDA pregnancies, recruited at 14-18 weeks of gestation...
December 11, 2015: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/26580546/twin-anemia-polycythemia-sequence-perinatal-management-and-outcome
#17
Eran Ashwal, Yoav Yinon, Michal Fishel-Bartal, Abraham Tsur, Benjamin Chayen, Boaz Weisz, Shlomo Lipitz
OBJECTIVE: To determine the perinatal outcome of monochorionic twin pregnancies complicated by twin anemia-polycythemia sequence (TAPS). METHODS: All monochorionic twins diagnosed with TAPS between 2011 and 2014 were included. Each twin pair with TAPS (study group) was compared with 2 uncomplicated monochorionic twin pairs who were matched for gestational age at delivery (control group). Neonatal morbidity and mortality were evaluated. RESULTS: During the study period, 179 monochorionic twins were followed at our center, of whom 46 underwent laser ablation due to twin-to-twin transfusion syndrome...
2016: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/26517964/postnatal-survival-after-endoscopic-equatorial-laser-for-the-treatment-of-twin-to-twin-transfusion-syndrome
#18
Nicola Persico, Isabella Fabietti, Francesco D'Ambrosi, Maria Riccardi, Simona Boito, Luigi Fedele
BACKGROUND: Endoscopic laser coagulation of placental anastomoses is the first-line treatment for severe twin-to-twin transfusion syndrome. A recent randomized controlled trial reported that laser coagulation along the entire vascular equator was associated with a similar dual survival and survival of at least 1 twin compared with the group that was treated with the selective technique. In addition, there was a significantly lower incidence of postoperative recurrence of twin-to-twin transfusion syndrome and the development of twin anemia-polycythemia sequence in the equatorial group...
April 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26405805/short-term-postnatal-renal-function-in-twin-anemia-polycythemia-sequence
#19
Lianne Verbeek, Femke Slaghekke, Romain Favre, Marine Vieujoz, Francesco Cavigioli, Gianluca Lista, Dick Oepkes, Enrico Lopriore
OBJECTIVE: To evaluate the short-term renal function in neonates with twin anemia-polycythemia sequence (TAPS). METHODS: All consecutive monochorionic twins with TAPS with double survivors admitted to three European centers were included in this retrospective study. Each twin pair was matched for gestational age at birth with a control twin pair unaffected by TAPS or twin-twin transfusion syndrome. Creatinine and urea levels in the first week after birth were recorded...
2016: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/26297943/neurodevelopmental-outcome-at-2-years-in-twin-twin-transfusion-syndrome-survivors-randomized-for-the-solomon-trial
#20
RANDOMIZED CONTROLLED TRIAL
Jeanine M M van Klink, Femke Slaghekke, Marina A Balestriero, Barbara Scelsa, Paola Introvini, Mariangela Rustico, Stefano Faiola, Monique Rijken, Hendrik M Koopman, Johanna M Middeldorp, Dick Oepkes, Enrico Lopriore
BACKGROUND: The preferred treatment for twin-twin transfusion syndrome is fetoscopic laser coagulation of inter-twin vascular anastomoses on the monochorionic placenta. Severe postoperative complications can occur when inter-twin vascular anastomoses remain patent including twin-anemia polycythemia sequence or recurrent twin-twin transfusion syndrome. To minimize the occurrence of residual anastomoses, a modified laser surgery technique, the Solomon technique, was developed in which the entire vascular equator is coagulated...
January 2016: American Journal of Obstetrics and Gynecology
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