Perinatal outcome after TAPS

Perinatal outcome in TAPS is not well known and appears to vary according to the severity of TAPS, reflecting the heterogeneous aspect of TAPS.Outcome may vary from two healthy neonates with large intertwin Hb discordance to severe neonatal morbidity or neonatal death.2-5

Neonatal morbidity in TAPS may be limited to hematological problems at birth. Donor twins may be severely anemic and require blood transfusions, whereas recipient twins may be severely polycythemic and require partial exchange transfusion. Recipient twins are more often trombocytopenic than donors, due to the polycythemia.2 However, several cases of severe neonatal morbidity have been described, incluing ischemic limb necrosis and severe cerebral injury resulting in neonatal death.3-5

Knowledge on the neonatal and long-term morbidity in TAPS is scarce and based on case reports and small series.

Reference List

(1) Slaghekke F, Kist WJ, Oepkes D, Pasman SA, Middeldorp JM, Klumper FJ et al. Twin anemia-polycythemia sequence: diagnostic criteria, classification, perinatal management and outcome.Fetal Diagn Ther 2010; 27(4):181-190.

(2)  Lopriore E, Slaghekke F, Oepkes D, Middeldorp JM, Vandenbussche FP, Walther FJ. Hematological characteristics in neonates with twin anemia-polycythemia sequence (TAPS). Prenetal Diagnosis 2010; 30(3):251-255.

(3) Lopriore E, Slaghekke F, Kersbergen KJ, de Vries LS, Drogtrop AP, Middeldorp JM et al. Severe cerebral injury in a recipient with twin anemia-polycythemia sequence. Ultrasound Obstet Gynecol 2013; 41(6):702-706.

(4) Luminoso D, Figueira CO, Marins M, Peralta CF. Fetal brain lesion associated with spontaneous twin anemia-polycythemia sequence. Ultrasound Obstet Gynecol 2013.

(5) Robyr R, Lewi L, Salomon LJ, Yamamoto M, Bernard JP, Deprest J, Ville Y. Prevalence and management of late fetal complications following successful selective laser coagulation of chorionic plate anastomoses in twin-to-twin transfusion syndrome. Am J Obstet Gynecol 2006; 194(3):796-803.