Fetal Intra-Peritoneal Transfusion for the Management of Very Early Spontaneous Twin Anemia-Polycythemia Sequence in an Obese Patient With a Whole Anterior Placenta

Article Article scientifique Article Fetal Intra-Peritoneal Transfusion for the Management of Very Early Spontaneous Twin Anemia-Polycythemia Sequence in an Obese Patient With a Whole Anterior Placenta eng 2016 author Guenot Cécile author Robyr Romaine 28612 author Jastrow Meyer Nicole 58960 author Vial Yvan author Raio Luigi author Baud David 154-157 10.1017/thg.2016.13 26996223 1832-4274 Twin anemia-polycythemia sequence (TAPS) is a rare condition in monochorionic twin pregnancies. Small intertwin placental vascular communications allow transfusion, which results in a hemoglobin difference in the twins in the absence of oligohydramnios or polyhydramnios. We report here a case of TAPS diagnosed at 17 weeks' gestation in an obese patient (BMI 42) with a whole anterior placenta. The only possible treatment at this stage of pregnancy was intra-uterine transfusion (IUT), which was repeated weekly until photocoagulation of placental anastomoses was feasible. Fetoscopic laser surgery is the only curative treatment, but is challenging in TAPS because of the absence of polyhydramnios and the presence of minuscule anastomoses. An anterior placenta and high BMI can make the procedure even more challenging. This case report demonstrates that very early and rapidly progressing TAPS with technically complicated conditions (elevated BMI and anterior placenta) can be successfully managed with IUT until laser procedure is achievable. Adult Anemia/etiology/pathology/therapy Blood Transfusion, Intrauterine/methods Female Fetofetal Transfusion/complications/pathology/therapy Gestational Age Humans Laser Coagulation Obesity/complications/pathology Placenta/pathology Polycythemia/etiology/pathology/therapy Pregnancy Pregnancy, Twin Twins, Monozygotic Ultrasonography, Prenatal Dewey 618 58 Département de pédiatrie, gynécologie et obstétrique 223 false Twin Research and Human Genetics 19 2 a17e1cce-4354-4870-96b8-d47a7f291e0e Article (Published version) Restricted Guenot-2016-Fetal Intra-Peritone.pdf 202680 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique

Title	Published in	Year	Views	Downloads

Fetal Intra-Peritoneal Transfusion for the Management of Very Early Spontaneous Twin Anemia-Polycythemia Sequence in an Obese Patient With a Whole Anterior Placenta	Twin Research and Human Genetics	2016	481	0
Etude pilote de dépistage du cancer du col de l'utérus dans une région rurale camerounaise		2002	1,709	3,193

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Robyr, Romaine