2021
DOI: 10.1002/uog.23585
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Perinatal outcome of pregnancy complicated by twin anemia–polycythemia sequence: systematic review and meta‐analysis

Abstract: What are the novel findings of this work? Spontaneous twin anemia-polycythemia sequence (TAPS) may have a better prognosis than postlaser TAPS. No substantial difference was noted in terms of perinatal mortality and morbidity between TAPS pregnancies managed expectantly and those treated with laser surgery, intrauterine transfusion or selective reduction. What are the clinical implications of this work?The present meta-analysis provides pooled estimates of the risks of perinatal mortality and morbidity and pre… Show more

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Cited by 12 publications
(6 citation statements)
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“…UA PI > 95%, donor, in the selective reduction group. 29 In our study, all the post-laser TAPS cases were managed expectantly. While a stable and chronic clinical balance between anemic and polycythemic twins can be managed conservatively, authors consider worsening of fetal hemodynamic (worsening delta MCA PSV, UA absent or reversed end diastolic flow velocity, DV absent or reversed a-wave, pulsatile umbilical vein, and hydrops) a trigger for active prenatal fetal intervention.…”
Section: Discussionmentioning
confidence: 87%
See 1 more Smart Citation
“…UA PI > 95%, donor, in the selective reduction group. 29 In our study, all the post-laser TAPS cases were managed expectantly. While a stable and chronic clinical balance between anemic and polycythemic twins can be managed conservatively, authors consider worsening of fetal hemodynamic (worsening delta MCA PSV, UA absent or reversed end diastolic flow velocity, DV absent or reversed a-wave, pulsatile umbilical vein, and hydrops) a trigger for active prenatal fetal intervention.…”
Section: Discussionmentioning
confidence: 87%
“…Some have proposed reversal of the usual sequence of the sequential selective method of coagulation of the intraplacental vessels in order to preserve the vascular volume of the anemic fetus 28 . A recent systematic review investigated the incidence of severe neonatal morbidity stratified by different management options and that was 27.3% in the expectant management groups, 28.7% in the laser group, 38.2% in the IUT group, and 23.3% in the selective reduction group 29 . In our study, all the post‐laser TAPS cases were managed expectantly.…”
Section: Discussionmentioning
confidence: 99%
“…TAPS is suspected when the donor MCA-PSV is > 1.5 multiples of the median (MoM) and recipient MCA-PSV is < 1.0 MoM 7 or when there is a large (> 0.5 MoM) intertwin difference in MCA-PSV 8 . In pregnancies complicated by TAPS, it remains unclear whether elevated MCA-PSV in the donor twin, reduced MCA-PSV in the recipient twin or both contribute to increased fetal death associated with TAPS 9,10 . Moreover, a proportion of pregnancies complicated by TTTS have elevated MCA-PSV in the donor twin but do not fulfill the abovementioned diagnostic criteria for TAPS; the clinical significance of isolated elevation of MCA-PSV in the donor twin in pregnancies complicated by TTTS remains unclear.…”
Section: Introductionmentioning
confidence: 99%
“…Mothers with multiple pregnancies may be more vulnerable to a range of complications during pregnancy [ 8 ], including but not limited to gestational hypertension [ 9 ], gestational diabetes mellitus [ 10 ], antepartum hemorrhage [ 11 ], preterm birth [ 12 ], and anemia [ 13 ]. Pregnancy complications can cause adverse outcomes for mother and child, and even have long-term adverse effects on offspring [ 14 , 15 ].…”
Section: Introductionmentioning
confidence: 99%