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Title

Fetal Intra-Peritoneal Transfusion for the Management of Very Early Spontaneous Twin Anemia-Polycythemia Sequence in an Obese Patient With a Whole Anterior Placenta
Authors
Guenot, Cécile
Robyr, Romaine
Jastrow Meyer, Nicole
Vial, Yvan
Raio, Luigi
Baud, David
Published in Twin Research and Human Genetics. 2016, vol. 19, no. 2, p. 154-157
Abstract 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.
Keywords 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
Identifiers
PMID: 26996223
Full text
Article (Published version) (198 Kb) - document accessible for UNIGE members only Limited access to UNIGE
Structures
Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique
Citation
(ISO format) 		GUENOT, Cécile et al. Fetal Intra-Peritoneal Transfusion for the Management of Very Early Spontaneous Twin Anemia-Polycythemia Sequence in an Obese Patient With a Whole Anterior Placenta. In: Twin Research and Human Genetics, 2016, vol. 19, n° 2, p. 154-157. doi: 10.1017/thg.2016.13 https://archive-ouverte.unige.ch/unige:97808

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Deposited on : 2017-10-19

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