Twin-Twin Transfusion Syndrome with Anemia-Polycythemia: Prevalence, Characteristics, and Outcome

Journal of Clinical Medicine
Lisanne S A TollenaarE Lopriore

Abstract

The aim of this study was to estimate the prevalence of co-existing anemia-polycythemia (AP) in twin pregnancies with twin-twin transfusion syndrome (TTTS) prior to laser surgery, and to evaluate the characteristics and outcomes in TTTS twins with and without AP. All TTTS cases treated with laser between 2001 and 2019 were retrospectively reviewed for the presence of AP before surgery. AP was defined as delta middle cerebral artery-peak systolic velocity > 0.5 multiples of the median. The primary outcome was a composite of perinatal survival and severe neurodevelopmental impairment (NDI). Secondary outcomes included procedure-related characteristics, severe neonatal morbidity, and disease-free survival. In total, 66% (461/696) of TTTS twin pregnancies were eligible for analysis. AP was detected in 15% (70/461) of the TTTS twins prior to laser surgery. Gestational age at laser was higher in the TTTS+AP group compared to the TTTS-only group-21.0 weeks (interquartile rage (IQR): 18.8-24.0) versus 19.3 weeks (IQR: 17.3-21.9), respectively (p < 0.0001). Fewer placental anastomoses were detected in the TTTS+AP group than in the TTTS-only group-five (IQR: 4-6) versus six (IQR: 5-8), respectively (p < 0.0001). Perinatal survival was 77...Continue Reading

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Citations

Oct 20, 2019·Journal of Clinical Medicine·Enrico LoprioreAsma Khalil
Sep 9, 2020·Acta Obstetricia Et Gynecologica Scandinavica·Xueju WangPengbo Yuan

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