Perinatal outcomes of twin-to-twin transfusion syndrome associated with evidence of twin anemia polycythemia using different standardized definitions

• Published in: European journal of obstetrics & gynecology and reproductive biology Vol. 279; pp. 45 - 49
• Main Authors: Nassr, Ahmed A., Gessner, McKenna, Mostafaei, Shayan, Hessami, Kamran, Espinoza, Jimmy, Donepudi, Roopali V., Sanz Cortes, Magdalena, Krispin, Eyal, Sun, Raphael C., Qaderi, Shohra, Turan, Ozhan M., Mustafa, Hiba J., Harman, Christopher, Belfort, Michael A., Shamshirsaz, Alireza A.
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.12.2022
• Subjects: Doppler; Medicin och hälsovetenskap; Perinatal outcome; Twin anemia polycythemia sequence; Twin-to-twin transfusion syndrome; Perinatal outcome; Twin-to-twin transfusion syndrome; Doppler; Twin anemia polycythemia sequence
• ISSN: 0301-2115; 1872-7654; 1872-7654
• DOI: 10.1016/j.ejogrb.2022.10.007

To evaluate the survival of twin-to-twin transfusion syndrome (TTTS) and concomitant twin anemia polycythemia sequence (TAPS) compared to TTTS without TAPS at the time of fetoscopic laser photocoagulation (FLP). TTTS pregnancies undergoing FLP were divided to three groups including (i) traditional TAPS definition of middle cerebral artery (MCA) peak systolic velocity (PSV) < 1 multiple of the median (MoM) in recipient and > 1.5 MoM in the donor fetus, (ii) delta MCA-PSV > 0.5 MoM and (iii) delta MCA-PSV > 1.0 MoM. A total of 353 monochorionic twins underwent FLP for TTTS. Based on the traditional definition, 335 (94.9 %) had TTTS only and 18 (5.1 %) had TTTS + TAPS. There were 245 (69.4 %) TTTS only and 108 (30.6 %) TTTS + TAPS considering delta MCA-PSV > 0.5 MoM and 339 (96 %) TTTS only and 14 (4 %) TTTS + TAPS considering delta MCA-PSV > 1.0 MoM. No significant differences in survival were noted at birth or 30-days after delivery between TTTS and TTTS with TAPS patients using the traditional definition, delta > 0.5 MoM or delta > 1.0 MoM. The rate of neonatal survival at birth or at 30-days of life following FLP for TTTS only and TTTS with TAPS were not different based on any of the clinically used TAPS definitions.