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​Cihat Şen, ​Nicola Volpe

Cecilia Villalain, Daniel Rolnik, M. Mar Gil

Managing Editors
Murat Yayla, Oluş Api

Statistics Editor
Resul Arısoy

Article info

Ultrasound assessement of twin anemia polycetemia sequence. Perinatal Journal 2014;22(3):SE37 DOI: 10.2399/prn.14.S001084

Author(s) Information

Fatma Douik,
Kaouther Dimassi,
Mariem Ajroudi,
Raouia Radhouani,
Nizar Ben Aissia,
Amel Triki,
Mohamed Faouzi Gara

  1. Department of Obstetrics and Gynecology, Mongi Slim Hospital- La Marsa TN

Kaouther Dimassi, Department of Obstetrics and Gynecology, Mongi Slim Hospital- La Marsa TN,

Publication History
Conflicts of Interest

No conflicts declared.

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.

It’s about two observations of patients treated in the department of gynecology and obstetrics of the Mongi Slim hospital Tunis in 2013.
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.
TAPS is fetal emergency. Ultrasound is the only mean for the diagnosis and for the fetal therapy.

Fetal, anemia, twins

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