Fetal Intra-Peritoneal Transfusion for the Management of Very Early Spontaneous Twin Anemia-Polycythemia Sequence in an Obese Patient With a Whole Anterior Placenta.

Guenot, Cécile; Robyr, Romaine; Jastrow, Nicole; Vial, Yvan; Raio, Luigi; Baud, David (2016). Fetal Intra-Peritoneal Transfusion for the Management of Very Early Spontaneous Twin Anemia-Polycythemia Sequence in an Obese Patient With a Whole Anterior Placenta. Twin Research and Human Genetics, 19(2), pp. 154-157. Cambridge University Press 10.1017/thg.2016.13

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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. Fetoscopic laser surgery is the only curative treatment, but is challenging in TAPS because of the absence of polyhydramnios and the presence of minuscule anastomoses. An anterior placenta and high BMI can make the procedure even more challenging. This case report demonstrates that very early and rapidly progressing TAPS with technically complicated conditions (elevated BMI and anterior placenta) can be successfully managed with IUT until laser procedure is achievable.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Raio, Luigi

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1832-4274

Publisher:

Cambridge University Press

Language:

English

Submitter:

Monika Zehr

Date Deposited:

10 May 2017 11:35

Last Modified:

06 Oct 2017 11:55

Publisher DOI:

10.1017/thg.2016.13

PubMed ID:

26996223

Uncontrolled Keywords:

TAPS; intraperitoneal fetal transfusion; intrauterine transfusion; laser photocoagulation of placental anastomoses; monochorionic twin pregnancy; twin anemia-polycythemia sequence

BORIS DOI:

10.7892/boris.94571

URI:

https://boris.unibe.ch/id/eprint/94571

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