Fortún Agud Marina, Marfil González María, Monis Rodríguez Susana, Suarez Arana Maria, Blasco Alonso Marta, Jimenez Lopez Jesus, Narbona Arias Isidoro
Obstetrics and Gynecology, Materno-Infantil Hospital Regional Universitaria Málaga, Avenue Arroyo de los Ángeles S/N, 29011 Málaga, Spain.
Department of Surgical Specialties, University of Malaga, 29010 Málaga, Spain.
Life (Basel). 2024 Aug 27;14(9):1071. doi: 10.3390/life14091071.
Twin anemia-polycythemia sequence (TAPS) in monochorionic twin pregnancies is a potentially serious complication caused by unidirectional vascular anastomoses in the placenta, resulting in one anemic donor twin and one polycythemic recipient twin. Diagnosis of this condition is achieved through Doppler ultrasound assessment of the difference between the MoM of the peak systolic velocity of the middle cerebral artery between the twins, establishing the diagnosis with a delta value >0.5 MoM. Management of this situation is individualized and may include intrauterine transfusions, intrauterine laser treatment, and expectant management through ultrasound monitoring of both fetuses to prevent complications. In severe cases, pregnancy termination may be necessary. It is essential that these pregnancies are managed by a multidisciplinary team of professionals, including obstetricians specialized in fetal medicine and neonatologists, to ensure the best possible outcome for both the mother and the fetuses. Early detection and treatment are crucial in the management of pregnancies complicated by twin anemia-polycythemia sequence. The main objective of this article is to conduct a review of the existing literature on the anemia-polycythemia sequence in monochorionic pregnancies, emphasizing the exceptional nature of the presented case due to its spontaneous occurrence, which has a very low prevalence compared to post-laser TAPS cases. It also discusses the different treatment options, highlighting the importance of expectant management and individualization in each case.
单绒毛膜双胎妊娠中的双胎贫血-红细胞增多序列征（TAPS）是一种由胎盘单向血管吻合引起的潜在严重并发症，导致一个贫血供血胎儿和一个红细胞增多受血胎儿。通过多普勒超声评估双胎大脑中动脉收缩期峰值速度的中位数倍数（MoM）之间的差异来诊断这种情况，当差值>0.5 MoM时确立诊断。这种情况的管理是个体化的，可能包括宫内输血、宫内激光治疗，以及通过超声监测两个胎儿进行期待管理以预防并发症。在严重情况下，可能需要终止妊娠。至关重要的是，这些妊娠应由多学科专业团队管理，包括胎儿医学专科的产科医生和新生儿科医生，以确保母亲和胎儿都能获得尽可能好的结局。早期发现和治疗对于处理并发双胎贫血-红细胞增多序列征的妊娠至关重要。本文的主要目的是对单绒毛膜妊娠中贫血-红细胞增多序列征的现有文献进行综述，强调所呈现病例的特殊性，即其自发发生，与激光治疗后发生的TAPS病例相比，其患病率非常低。文章还讨论了不同的治疗选择，强调了期待管理和每个病例个体化的重要性。
