Twin anemia-polycythemia sequence

Twin anemia-polycythemia sequence (TAPS) is a rare complication that occurs in monochorionic twin pregnancies. Monochorionic twins share a single placenta, which can lead to complications such as TAPS. This condition is characterized by a significant imbalance in the hemoglobin levels of the twins, with one twin becoming anemic (low hemoglobin) and the other developing polycythemia (high hemoglobin).

Etiology

The exact cause of TAPS is not fully understood. However, it is believed to be due to the presence of tiny anastomoses (connections) between the blood vessels of the twins within the shared placenta. These anastomoses allow for unequal blood exchange between the twins, leading to one twin receiving more blood (polycythemic twin) and the other receiving less (anemic twin).

Diagnosis

TAPS can be diagnosed either antenatally (before birth) or postnatally (after birth). Antenatal diagnosis is usually made through Doppler ultrasonography, which can detect the characteristic blood flow patterns in the twins. Postnatal diagnosis is based on the significant difference in hemoglobin levels between the twins at birth.

Treatment

The treatment for TAPS depends on the severity of the condition and the stage of pregnancy. Options include expectant management, laser therapy to disrupt the anastomoses, or early delivery if the condition is severe and the pregnancy is near term.

Prognosis

The prognosis for TAPS varies depending on the severity of the condition and the timing of diagnosis and treatment. With early detection and appropriate treatment, the prognosis can be favorable. However, untreated TAPS can lead to serious complications such as heart failure in the polycythemic twin and high-output cardiac failure in the anemic twin.

See also

• Twin-to-twin transfusion syndrome
• Monochorionic twins
• Placenta

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