scholarly journals OP15.06: Monochorionic twins complicated by twin anemia polycythemia sequence: perinatal outcome following intrauterine blood transfusion

2018 ◽  
Vol 52 ◽  
pp. 110-110
Author(s):  
Y. Yinon ◽  
A. Shmueli ◽  
N. Duvdevani ◽  
B. Chayen ◽  
B. Weisz ◽  
...  
2021 ◽  
Vol 20 (2) ◽  
pp. 134-140
Author(s):  
A.V. Mikhailov ◽  
◽  
A.N. Romanovsky ◽  
T.A. Kashtanova ◽  
A.A. Kuznetsov ◽  
...  

Twin anemia polycythemia sequence (TAPS) is a specific complication of the monochorionic multiple birth, which is based on chronic feto-fetal blood transfusion over placental vascular anastomoses, and the main clinical symptom is discordant fetal hemoglobin level in the absence amniotic fluid imbalance. Currently, there is no generally recognized consensus on the optimal treatment tactics. Dynamic observation, labor, intrauterine blood transfusion, selective fetocide, fetoscopic laser coagulation of placental vascular anastomoses are applied, although the latter is recognized by the majority of researchers as the most promising method for treating TAPS. There are disagreements in estimating the frequency of perinatal morbidity and mortality during pregnancy, complicated by the development of TAPS, and their real value has not yet been completely defined. Key words: intrauterine transfusion, Solomon method, monochorionic twins, twin anemia polycythemia sequence, fetoscopic laser coagulation


2016 ◽  
Vol 5 (2) ◽  
pp. 127-129
Author(s):  
Theodore Dassios ◽  
Kamal Ali ◽  
Ann Hickey ◽  
Anne Greenough

Abstract Background: Intrauterine blood transfusion is an important treatment of foetal anaemia. Although the standard access to the foetal vasculature for transfusion is the umbilical vein, the intracardiac route is used when foetal or placental positions make other accesses technically challenging. Intrauterine, intracardiac blood transfusion is associated with complications including haemopericardium, damage to cardiac tissues and foetal bradycardia. Highlights of the present report: We report a case of monochorionic twins with twin anaemia-polycythaemia sequence (TAPS). Intracardiac, intrauterine blood transfusion of the donor twin was complicated by haemopericardium and sustained bradycardia which necessitated delivery by emergency caesarean section. Postnatally, the bradycardia was sustained and was diagnosed electrocardiographically as heart block, which spontaneously reversed on the second day after birth. The management of heart block in the neonatal period is discussed. Conclusion: Foetal intracardiac intrauterine blood transfusion can be associated with transient congenital heart block (CHB).


2013 ◽  
Vol 34 (2) ◽  
pp. 121-126 ◽  
Author(s):  
L. Genova ◽  
F. Slaghekke ◽  
F.J. Klumper ◽  
J.M. Middeldorp ◽  
S.J. Steggerda ◽  
...  

2011 ◽  
Vol 14 (5) ◽  
pp. 457-462 ◽  
Author(s):  
Boaz Weisz ◽  
Liat Hogen ◽  
Yoav Yinon ◽  
Liat Gindes ◽  
Alon Shrim ◽  
...  

Objective: To evaluate the perinatal outcome of MC twins with selective IUGR (sIUGR).Study design: A prospective study, which included three groups of MC twins: Group A, uncomplicated MC twin pregnancies (n = 91); group B, sIUGR with normal umbilical artery Doppler (n = 19); and group C, sIUGR with abnormal (absence or reversed EDV) umbilical artery Doppler (n = 18). The latter were routinely hospitalized in the high-risk ward under strict surveillance.Results: Neonatal outcome of fetuses complicated with sIUGR and normal Doppler was similar to controls. Neonates born to pregnancies complicated by sIUGR and abnormal Doppler had significantly increased incidence of CNS findings, RDS, NEC, sepsis, and neonatal death compared to controls. Adverse outcome in this group was independently associated only with gestational age at birth.Conclusion: The perinatal outcomes of MC twins complicated with sIUGR and normal Doppler are similar to uncomplicated MC pregnancies. MC twins with sIUGR and abnormal Doppler have reasonable outcomes, yet significantly more neonatal complications compared to non-complicated MC twins.


Author(s):  
Sunanda N. ◽  
Akhila M. V.

Background: To study the incidence, management and to determine maternal and perinatal outcome in cases of twin pregnancy with one twin demise in the second half of the pregnancy.Methods: This retrospective study was carried out at Cheluvamba Hospital, a tertiary care hospital attached to Mysore medical college and research institute between September 2009 and 2014. 19 twin pregnancies complicated by single intrauterine fetal demise (IUFD) after 20 weeks of gestation were identified from the hospital records. Data collected included maternal age, parity, antenatal complications, cause of IUFD, gestational age at diagnosis, time interval between diagnosis of IUFD and delivery, mode of delivery, birth details, type of placentation and neonatal complications.Results: The incidence of twin with one twin demise was 2.056%. Mean gestational age at presentation was 33.86 weeks. Most common cause of death was growth discordance in 7 cases followed by placental insufficiency in 4 cases. 57.89% of cases had monochorionic placentation. Neonatal course was most commonly complicated by prematurity. Maternal course was uneventful in majority (63.15%) of cases with two maternal deaths due to intravascular coagulopathy sequelae.Conclusions: Single fetal death occurs more often in monochorionic twins. The main problem for the surviving twin is prematurity. It is very important to identify the chorionicity by ultrasound examination in early pregnancy and implement specific surveillance of monochorial pregnancies.


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