Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
Fetal Diagn Ther. 2010;27(4):181-90. doi: 10.1159/000304512. Epub 2010 Mar 26.
Monochorionic twins share a single placenta with intertwin 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 several complications, including twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS). TTTS and TAPS are both chronic forms of fetofetal transfusion. TTTS is characterized by the twin oligopolyhydramnios sequence, whereas TAPS is characterized by large intertwin hemoglobin differences in the absence of amniotic fluid discordances. TAPS may occur spontaneously in up to 5% of monochorionic twins and may also develop after incomplete laser treatment in TTTS cases. This review focuses on the pathogenesis, incidence, diagnostic criteria, management options and outcome in TAPS. In addition, we propose a classification system for antenatal and postnatal TAPS.
单绒毛膜性双胎共有一个胎盘，胎盘内存在血管吻合支，可以使血液在两个胎儿之间相互传递。这些吻合支是多种并发症（包括双胎输血综合征（TTTS）和双胎贫血-红细胞增多序列症（TAPS））发生的重要解剖学基础。TTTS 和 TAPS 都是胎儿间输血的慢性形式。TTTS 的特征是双胎羊水过少序列，而 TAPS 的特征是血红蛋白差值较大而羊水无差异。在多达 5%的单绒毛膜性双胎中可能会自发发生 TAPS，在 TTTS 病例激光治疗不完全后也可能会发生 TAPS。本综述重点关注 TAPS 的发病机制、发生率、诊断标准、处理选择和结局。此外，我们还提出了一种产前和产后 TAPS 的分类系统。
