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首页> 外文期刊>Placenta >Twin anemia-polycythemia sequence in two monochorionic twin pairs without oligo-polyhydramnios sequence.
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Twin anemia-polycythemia sequence in two monochorionic twin pairs without oligo-polyhydramnios sequence.

机译：两个没有绒毛羊水过多序列的单绒毛膜对中的双胞胎贫血-红细胞增多症序列。

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摘要

Placental vascular anastomoses in monochorionic twins may lead to acute or chronic inter-twin transfusion. We report an uncommon form of chronic inter-twin transfusion, referred to as twin anemia-polycythemia sequence (TAPS), with severe anemia in one twin and polycythemia in the other, without the characteristically associated twin oligo-polyhydramnios sequence (TOPS) seen in the classical twin-to-twin transfusion syndrome (TTTS). The clinical course and placental characteristics of two pairs of monochorionic twins with TAPS born at, respectively, 33 and 34 weeks' gestation were reviewed. Serial fetal ultrasound examinations revealed no signs of TOPS. At birth, both donor twins were severely anemic requiring blood transfusion and both recipients were polycythemic, one requiring partial volume exchange transfusions. Inter-twin difference in reticulocyte counts was extremely high, suggesting a chronic form of inter-twin blood transfusion. Placental injection studies revealed a preponderance of very small (<1mm) arterio-venous anastomoses in one direction. In conclusion, chronic inter-twin transfusion may lead to an uncommon form of inter-twin transfusion, named TAPS, not associated with TOPS, resulting in severe fetal or neonatal hematological complications. We hypothesize that TAPS is mediated through minuscule unidirectional anastomoses. TAPS can be diagnosed antenatally with Doppler studies and postnatally by hemoglobin and reticulocyte measurements.
机译：单绒毛膜双胎的胎盘血管吻合可能导致急性或慢性双胞胎输血。我们报告了一种罕见的慢性双胞胎间输血形式，称为双胞胎贫血-红细胞增多症序列（TAPS），其中一个双胞胎患有严重的贫血，另一双胞胎则患有红细胞增多症，而在经典的双胎双输血综合征（TTTS）。回顾了分别在妊娠33和34周时出生的两对具有TAPS的单绒毛膜双生子的临床过程和胎盘特征。连续的胎儿超声检查未发现TOPS征象。出生时，两个供体双胞胎都严重贫血，需要输血，两个接受者都是多囊性的，其中一个需要进行部分体积交换输血。网织红细胞计数的双胞胎间差异非常高，表明双胞胎间输血是一种慢性形式。胎盘注射研究显示，在一个方向上占优势的是很小的动静脉吻合（<1mm）。总之，慢性双胎间输血可能导致罕见的双胎间输血形式，即TAPS，与TOPS不相关，导致严重的胎儿或新生儿血液学并发症。我们假设TAPS通过微小的单向吻合介导。 TAPS可以在出生前通过多普勒检查进行诊断，在出生后通过血红蛋白和网织红细胞测量进行诊断。

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