Ultrasound assessement of twin anemia polycetemia sequence

Objective

Twin anemia polycythemia sequence (TAPS) is caused by small placental vascular anastomoses leading to chronic anemia in the donor and polycythemia in the recipient. TAPS can result in severe fetal or neonatal hematologic complications, cerebral injury and perinatal death. The aim of this study is to ascertain the most relevant echographic signs that helps to make an early diagnosis so we can improve the outcome of this sparse complication.

Methods

It’s about two observations of patients treated in the department of gynecology and obstetrics of the Mongi Slim hospital Tunis in 2013.

Results

The first case is about a 42 years old patient with one miscarriage, one childbirth, blood type O negative, actual pregnancy a spontaneous monochorionic according to the early first trimester echography, adressed at 31 SA for intra uterine death of one the twins and hydrops fetalis of the second.
The second patient is aged of 28 years, first pregnancy hospitalized at 29 SA to explore an hydramnios accidently discovered.The ultrasound exam performed in our service showed for the first twin: no bladder and anamnios, for the second twin: a huge bladder with polyhydramnios.
In this too cases, the blood flow in the MCA was superior to 1.5MoM. Furthermore ultrasound allowed the guidance for fetal transfusion.

Conclusion

TAPS is fetal emergency. Ultrasound is the only mean for the diagnosis and for the fetal therapy.

Keywords

Fetal, anemia, twins

	File/Dsecription
	Figure 1 Fetal ascitis
	Figure 2 Systolic blood flow in the MCA after fetal transfusion
	Figure 3 Systolic bloof flow in the MCA Before fetal transfusion