Abstract | INTRODUCTION:
Twin-twin transfusion syndrome (TTTS) and twin anemia- polycythemia sequence (TAPS) are classified as distinct clinical disorders associated with unbalanced blood flow through placental vascular communications. Typically, TAPS placentas demonstrate few <1 mm arteriovenous (AV) communications, and at fetoscopy the twins are visibly pale and plethoric. MATERIALS AND METHODS: In a cohort of TTTS patients who underwent laser surgery, those with preoperative findings suggestive of anemia/ polycythemia (AP) were compared to those with TTTS alone. AP was defined as middle cerebral artery peak systolic velocity in one twin >1.5 multiples of the median (MoM), and <1.0 MoM in the other. RESULTS: Of 369 TTTS patients, 9 (2.4%) met criteria for preoperative AP. The mean number (±SD) of AV communications in the TTTS + AP group was 5.6 ± 5.7, compared with 8.8 ± 4.8 in the TTTS-alone group (p = 0.013). Five TTTS + AP patients (56%) had a few thin AV communications (mean 2.8 ± 1.6); all 5 had visibly pale and plethoric twins. The remaining 4 (44%) had large or numerous anastomoses (mean 10.5 ± 6.8); none had fetal skin color discordance. DISCUSSION: Preoperative AP affected 2% of TTTS patients. Of these, approximately half had placental and skin color findings typically reported with isolated TAPS.
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Authors | Kristi R Van Winden, Ruben A Quintero, Eftichia V Kontopoulos, Lisa M Korst, Arlyn Llanes, Ramen H Chmait |
Journal | Fetal diagnosis and therapy
(Fetal Diagn Ther)
Vol. 37
Issue 4
Pg. 274-80
( 2015)
ISSN: 1421-9964 [Electronic] Switzerland |
PMID | 25721425
(Publication Type: Journal Article)
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Copyright | © 2015 S. Karger AG, Basel. |
Topics |
- Anemia
(complications, surgery)
- Female
- Fetofetal Transfusion
(complications, surgery)
- Fetoscopy
- Humans
- Laser Therapy
- Placenta
(blood supply)
- Polycythemia
(complications, surgery)
- Pregnancy
- Pregnancy, Twin
- Preoperative Period
- Treatment Outcome
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