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Geburtshilfe Frauenheilkd 2020; 80(03): 264-268
DOI: 10.1055/a-0864-4710
GebFra Magazin
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Georg Thieme Verlag KG Stuttgart · New York

Twin Anemia-Polycythemia Sequence (Zwillings-Anämie-Polyzythämie-Sequenz)

Christian Bamberg
,
Philipp Deindl
,
Kurt Hecher
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Publication Date:
04 March 2020 (online)

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Die Twin Anemia-Polycythemia Sequence (TAPS) ist eine Komplikation bei monochorialen Mehrlingsschwangerschaften. Verursacht wird sie durch wenige, dünne arteriovenöse Anastomosen zwischen den umbilikalen Kreisläufen auf der Plazentaoberfläche. Außerdem sind protektive arterioarterielle Gefäßverbindungen fehlend oder nur sehr dünn. Es handelt sich um eine atypische, chronische Form der interfetalen Transfusion, bei der es zu signifikanten Hämoglobinunterschieden zwischen den beiden Zwillingen kommt. In der Folge treten eine chronische Anämie beim Donor und eine Polyzythämie beim Rezipienten auf.
 

  • Literatur

  • 1 Lewi L, Jani J, Blickstein I. et al. The outcome of monochorionic diamniotic twin gestations in the era of invasive fetal therapy: a prospective cohort study. Am J Obstet Gynecol 2008; 199: 514.e1-514.e8
    CrossrefPubMedGoogle Scholar
  • 2 Habli M, Bombrys A, Lewis D. et al. Incidence of complications in twin-twin transfusion syndrome after selective fetoscopic laser photocoagulation: a single-center experience. Am J Obstet Gynecol 2009; 201: 417.e1-417.e7
    CrossrefPubMedGoogle Scholar
  • 3 Robyr R, Lewi L, Salomon LJ. et al. Prevalence and management of late fetal complications following successful selective laser coagulation of chorionic plate anastomoses in twin-to-twin transfusion syndrome. Am J Obstet Gynecol 2006; 194: 796-803
    CrossrefPubMedGoogle Scholar
  • 4 Khalil A, Rodgers M, Baschat A. et al. ISUOG Practice Guidelines: role of ultrasound in twin pregnancy. Ultrasound Obstet Gynecol 2016; 47: 247-263
    CrossrefPubMedGoogle Scholar
  • 5 Khalil A, Gordijn S, Ganzevoort W. et al. Consensus diagnostic criteria and monitoring of twin anemia polycythemia sequence: a Delphi procedure. Ultrasound Obstet Gynecol 2019; DOI: 10.1002/uog.21882.
    CrossrefPubMedGoogle Scholar
  • 6 Klaritsch P, Deprest J, Van Mieghem T. et al. Reference ranges for middle cerebral artery peak systolic velocity in monochorionic diamniotic twins: a longitudinal study. Ultrasound Obstet Gynecol 2009; 34: 149-154
    PubMedGoogle Scholar
  • 7 Tollenaar LS, Slaghekke F, Middeldorp JM. et al. Twin Anemia Polycythemia Sequence: Current Views on Pathogenesis, Diagnostic Criteria, Perinatal Management, and Outcome. Twin Res Hum Genet 2016; 19: 222-233
    CrossrefPubMedGoogle Scholar
  • 8 Tollenaar LSA, Lopriore E, Middeldorp JM. et al. Improved prediction of twin anemia-polycythemia sequence by delta middle cerebral artery peak systolic velocity: new antenatal classification system. Ultrasound Obstet Gynecol 2019; 53: 788-793
    CrossrefPubMedGoogle Scholar
  • 9 Tavares de Sousa M, Fonseca A, Hecher K. Role of fetal intertwin difference in middle cerebral artery peak systolic velocity in predicting neonatal twin anemia-polycythemia sequence. Ultrasound Obstet Gynecol 2019; 53: 794-797
    PubMedGoogle Scholar
  • 10 Lopriore E, Middeldorp JM, Oepkes D. et al. Twin anemia-polycythemia sequence in two monochorionic twin pairs without oligo-polyhydramnios sequence. Placenta 2007; 28: 47-51
    CrossrefPubMedGoogle Scholar
  • 11 Donepudi R, Papanna R, Snowise S. et al. Does anemia-polycythemia complicating twin-twin transfusion syndrome affect outcome after fetoscopic laser surgery?. Ultrasound Obstet Gynecol 2016; 47: 340-344
    CrossrefPubMedGoogle Scholar
  • 12 Van Winden KR, Quintero RA, Kontopoulos EV. et al. Pre-Operative Twin Anemia/Polycythemia in the Setting of Twin-Twin Transfusion Syndrome (TTTS). Fetal Diagn Ther 2015; 37: 274-280
    CrossrefPubMedGoogle Scholar
  • 13 Bamberg C, Diemert A, Glosemeyer P. et al. Quantified discordant placental echogenicity in twin anemia-polycythemia sequence (TAPS) and middle cerebral artery peak systolic velocity. Ultrasound Obstet Gynecol 2018; 52: 373-377
    CrossrefPubMedGoogle Scholar
  • 14 de Laat MW, Manten GT, Nikkels PG. et al. Hydropic placenta as a first manifestation of twin-twin transfusion in a monochorionic diamniotic twin pregnancy. J Ultrasound Med 2009; 28: 375-378
    CrossrefPubMedGoogle Scholar
  • 15 Segev Y, Goldberg Y, Riskin-Mashiah S. et al. Starry sky pattern of fetal liver sonogram as first sign of twin-twin transfusion syndrome. Ultrasound Obstet Gynecol 2012; 39: 723-725
    CrossrefPubMedGoogle Scholar
  • 16 Slaghekke F, Kist WJ, Oepkes D. et al. Twin anemia-polycythemia sequence: diagnostic criteria, classification, perinatal management and outcome. Fetal Diagn Ther 2010; 27: 181-190
    CrossrefPubMedGoogle Scholar
  • 17 Slaghekke F, Lopriore E, Lewi L. et al. Fetoscopic laser coagulation of the vascular equator versus selective coagulation for twin-to-twin transfusion syndrome: an open-label randomised controlled trial. Lancet 2014; 383: 2144-2151
    CrossrefPubMedGoogle Scholar
  • 18 Lanna MM, Faiola S, Consonni D. et al. Increased risk of placental abruption after solomon laser treatment of twin-twin transfusion syndrome. Placenta 2017; 53: 54-56
    CrossrefPubMedGoogle Scholar
  • 19 Lopriore E, Slaghekke F, Oepkes D. et al. Hematological characteristics in neonates with twin anemia-polycythemia sequence (TAPS). Prenat Diagn 2010; 30: 251-255
    CrossrefPubMedGoogle Scholar
  • 20 Lopriore E, Hecher K, Vandenbussche FP. et al. Fetoscopic laser treatment of twin-to-twin transfusion syndrome followed by severe twin anemia-polycythemia sequence with spontaneous resolution. Am J Obstet Gynecol 2008; 198: e4-e7
    PubMedGoogle Scholar
  • 21 Hillman SC, Morris RK, Kilby MD. Co-twin prognosis after single fetal death: a systematic review and meta-analysis. Obstet Gynecol 2011; 118: 928-940
    CrossrefPubMedGoogle Scholar
  • 22 Mackie FL, Rigby A, Morris RK. et al. Prognosis of the co-twin following spontaneous single intrauterine fetal death in twin pregnancies: a systematic review and meta-analysis. BJOG 2019; 126: 569-578
    PubMedGoogle Scholar
  • 23 Luminoso D, Figueira CO, Marins M. et al. Fetal brain lesion associated with spontaneous twin anemia-polycythemia sequence. Ultrasound Obstet Gynecol 2013; 42: 721-722
    CrossrefPubMedGoogle Scholar
  • 24 Verbeek L, Slaghekke F, Hulzebos CV. et al. Hypoalbuminemia in donors with twin anemia-polycythemia sequence: a matched case-control study. Fetal Diagn Ther 2013; 33: 241-245
    CrossrefPubMedGoogle Scholar
  • 25 Verbeek L, Slaghekke F, Favre R et al. Short-Term Postnatal Renal Function in Twin Anemia-Polycythemia Sequence. Fetal Diagn Ther 2016; 39: 192-197
    CrossrefPubMedGoogle Scholar
  • 26 Lopriore E, Slaghekke F, Kersbergen KJ. et al. Severe cerebral injury in a recipient with twin anemia-polycythemia sequence. Ultrasound Obstet Gynecol 2013; 41: 702-706
    CrossrefPubMedGoogle Scholar
  • 27 Slaghekke F, van Klink JM, Koopman HM. et al. Neurodevelopmental outcome in twin anemia-polycythemia sequence after laser surgery for twin-twin transfusion syndrome. Ultrasound Obstet Gynecol 2014; 44: 316-321
    PubMedGoogle Scholar
  • 28 Tollenaar LSA, Lopriore E, Slaghekke F. et al. High risk of long-term impairment in donor twins with spontaneous twin anemia polycythemia sequence. Ultrasound Obstet Gynecol 2019; DOI: 10.1002/uog.20846.
    CrossrefPubMedGoogle Scholar
  • 29 Lopriore E, Lewi L, Khalil A. Monochorionic Twins: A Delicate Balance. J Clin Med 2019; 8: 1711
    CrossrefPubMedGoogle Scholar