Managing two cases of twin anemia-polycythemia sequence in monochorionic twin pregnancies

单绒毛膜双胎妊娠中两例双胎贫血-红细胞增多症序列的管理

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Abstract

BACKGROUND: Twin anemia-polycythemia sequence (TAPS) is a rare monochorionic complication. In this study, we discuss the management of two cases of TAPS with different conditions. CASE PRESENTATION: Patient 1 was a 34-year-old multigravida in whom the fetal middle cerebral artery peak systolic velocities (MCA-PSVs) were 0.86 multiples of the median (MoM) and 2.0 MoM at 33 weeks of gestation. After cesarean section, stage 3 TAPS was confirmed according to the ultrasound findings and hemoglobin results of the newborns and placenta examination after birth. Patient 2 was a nulligravida who was diagnosed with stage 2 TAPS at 18 weeks of gestation. The patient underwent fetoscopic laser surgery. Ultrasonography monitoring of the MCA-PSVs was performed on a schedule after surgery, with a good status but selective intrauterine growth restriction of one cotwin. The newborns reached their normal development milestones after spontaneous preterm birth. CONCLUSION: Optimal management should be carefully selected for patients with different TAPS conditions.

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