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Chapter 14 - Management of Twin Anaemia-Polycythaemia Sequence

Published online by Cambridge University Press:  11 October 2022

By
Liesbeth Lewi  and
Enrico Lopriore
Edited by
Leanne Bricker ,
Julian N. Robinson  and
Baskaran Thilaganathan
Leanne Bricker
Affiliation:
Corniche Hospital, Abu Dhabi
Julian N. Robinson
Affiliation:
Brigham & Women's Hospital, Boston
Baskaran Thilaganathan
Affiliation:
St George's Hospital Medical School, University of London
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Summary

Twin anemia-polycythemia sequence (TAPS) is a transfusion imbalance unique to monochorionic twin pregnancies, characterized by anemia in the donor and polycythemia in the recipient. TAPS is caused by a chronic transfer of blood through minuscule anastomoses. TAPS can be diagnosed before birth by measuring the middle cerebral artery peak systolic velocities in both twins. If not detected, TAPS may lead to fetal demise. Although we do not know the best management, fetoscopic laser surgery and intrauterine transfusion of the donor with partial exchange transfusion of the recipient, may improve the outcome and prolong the pregnancy. Therefore, current guidelines recommend that we should screen monochorionic twin pregnancies for the occurrence of TAPS. In this chapter, we address our current understanding of TAPS, as well as the issues that need further research. We also propose a management plan based on the severity of the disease and the gestational age at presentation.

Type
Chapter
Information
Management of Multiple Pregnancies
A Practical Guide
 , pp. 147 - 156
Publisher: Cambridge University Press
Print publication year: 2022

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References

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