Fetal intraperitoneal transfusion for iatrogenic twin anemia–polycythemia sequence after laser therapy

Twin anemia–polycythemia sequence (TAPS) is a rare variant of twin–twin transfusion syndrome (TTTS) without the characteristic twin oligohydramnios–polyhydramnios sequence and cardiovascular milieu attributed to renin–angiotensin system mediators. It can occur spontaneously or iatrogenically after f...

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Bibliographic Details
Published in:Ultrasound in obstetrics & gynecology 2009-05, Vol.33 (5), p.592-594
Main Authors: Herway, C., Johnson, A., Moise, K., Moise, K. J.
Format: Article
Language:English
Subjects:
Adult
Anemia - therapy
Anemias. Hemoglobinopathies
Biological and medical sciences
Blood Flow Velocity - physiology
Blood Transfusion, Intrauterine - methods
Diseases of red blood cells
Erythrocyte Transfusion - methods
Female
Fetofetal Transfusion - diagnostic imaging
Fetofetal Transfusion - surgery
Fetoscopy - methods
Gestational Age
Gynecology. Andrology. Obstetrics
Hematologic and hematopoietic diseases
Humans
intrauterine intraperitoneal transfusion
intravascular intrauterine transfusion
Laser Coagulation - adverse effects
Medical sciences
Placenta - physiopathology
Placenta - surgery
Polycythemia - therapy
Polycythemias
Pregnancy
TAPS
TTTS
twin anemia–polycythemia sequence
twin–twin transfusion syndrome
Ultrasonography, Prenatal
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Summary:Twin anemia–polycythemia sequence (TAPS) is a rare variant of twin–twin transfusion syndrome (TTTS) without the characteristic twin oligohydramnios–polyhydramnios sequence and cardiovascular milieu attributed to renin–angiotensin system mediators. It can occur spontaneously or iatrogenically after fetoscopic laser surgery. We report the case of a woman, gravida 2 para 1, with a monochorionic diamniotic pregnancy who developed Quintero Stage III TTTS. She underwent laser photocoagulation of identifiable anastomotic vessels and subsequently developed suspected TAPS 2 weeks later. The pregnancy was successfully treated with serial intrauterine intraperitoneal transfusions (IUT‐PTs) of red blood cells. Although TAPS is a rare condition, serial middle cerebral artery peak systolic velocity measurements are warranted as follow‐up in patients who have undergone fetoscopic laser surgery for TTTS. IUT‐PTs may be superior to intravascular intrauterine transfusions in the treatment of this condition. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.
ISSN:0960-7692
1469-0705
DOI:10.1002/uog.6334