Slaghekke F, Kist W J, Oepkes D, Middeldorp J M, Klumper F J, Vandenbussche F P H A, Lopriore E
Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
Z Geburtshilfe Neonatol. 2009 Dec;213(6):248-54. doi: 10.1055/s-0029-1241884. Epub 2010 Jan 22.
Monochorionic twins share a single placenta with inter-twin vascular anastomoses, allowing the transfer of blood from one fetus to the other and vice versa. These anastomoses are the essential anatomical substrate for the development of severe complications, including twin-twin transfusion syndrome (TTTS) and twin-anemia-polycythemia sequence (TAPS). TTTS and TAPS are both chronic forms of feto-fetal transfusion. TTTS is characterized by the twin oligo-polyhydramnios sequence (TOPS), whereas TAPS is characterized by large inter-twin hemoglobin differences in the absence of amniotic fluid discordances. TAPS may occur spontaneously in a minority of monochorionic twins or in TTTS cases after laser treatment. This review focuses on the differences between TAPS and TTTS in terms of pathogenesis, incidence, diagnostic criteria, treatment modalities, perinatal outcome and long-term outcome.
单绒毛膜双胎共用一个胎盘，存在双胎间血管吻合，使得血液能够在两个胎儿之间相互转移。这些吻合是包括双胎输血综合征（TTTS）和双胎贫血-红细胞增多序列征（TAPS）在内的严重并发症发生发展的重要解剖学基础。TTTS和TAPS均为胎儿-胎儿输血的慢性形式。TTTS的特征是双胎羊水过少-过多序列征（TOPS），而TAPS的特征是在羊水量无差异的情况下双胎间血红蛋白差异巨大。TAPS可能在少数单绒毛膜双胎中自发出现，或在TTTS病例接受激光治疗后发生。本综述重点关注TAPS和TTTS在发病机制、发病率、诊断标准、治疗方式、围产期结局和长期结局方面的差异。
