Hematological Characteristics in Neonates With Twin-Twin Blood Transfusion

Abstract

We encountered a case of subacute twin-twin transfusion syndrome (TTTS) with the increased inter-twin reticulocyte count-ratio (calculated by dividing the reticulocyte count of the donor by the reticulocyte count of the recipient). In the current case, inter-twin reticulocyte count-ratio was increased to 1.91 (normal < 1.7); however, we diagnosed the case as subacute TTTS because a myocardial hypertrophy indicating the presence of chronic heart load was not recognized in the twins.

Twin anemia‐polycythemia sequence with suspected cardiac dysfunction

“…The diagnosis was solidified by the increased reticulocyte level in the donor anemic twin and the placenta with marked color asymmetry (Figure 4 ). 2 The cardiomegaly with pericardial effusion also indicated the presence of chronic stress on the heart in twin B. Twin A required intravenous infusion of 4.4% human serum albumin for correction of polycythemia, while twin B required a transfusion of red cell concentrate. The case should have been diagnosed and treated during pregnancy; however, fortunately, they had normal development at the 18‐month follow‐up.…”