Suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report

Background Twin anemia polycythemia sequence is a rare complication in monochorionic twin pregnancy. Case presentation We describe a case of dichorionic twin pregnancy presenting with suspected twin anemia polycythemia sequence. A 31-year-old White female, on her third pregnancy, had a routine ultra...
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Autor*in:	Jeyaseelan, Tania [verfasserIn] Shangaris, Panicos Efthymiou, Athina Martin, Linzi Story, Lisa Nanda, Surabhi Gupta, Neelam Al-Adnani, Mudher Marnerides, Andreas Nicolaides, Kypros H. Sankaran, Srividhya

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	TAPS Fetal therapy Dichorionic twins Fetal blood transfusion

Anmerkung:	© The Author(s) 2023

Übergeordnetes Werk:	Enthalten in: Journal of medical case reports - London : BioMed Central, 2007, 17(2023), 1 vom: 29. Jan.
Übergeordnetes Werk:	volume:17 ; year:2023 ; number:1 ; day:29 ; month:01

Links:	Volltext

DOI / URN:	10.1186/s13256-023-03766-8

Katalog-ID:	SPR051398354

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520			\|a Background Twin anemia polycythemia sequence is a rare complication in monochorionic twin pregnancy. Case presentation We describe a case of dichorionic twin pregnancy presenting with suspected twin anemia polycythemia sequence. A 31-year-old White female, on her third pregnancy, had a routine ultrasound scan at 12 weeks gestation, which demonstrated a dichorionic twin pregnancy with one placenta located in the anterior wall and the other in the posterior wall of the uterus. At 21 weeks, a scan demonstrated a 24% growth discordance between the two fetuses with normal Doppler studies and amniotic fluid. At 27 weeks, one twin showed signs of anemia and the other polycythemia; the fetal middle cerebral artery peak systolic velocity was high in the anemic fetus and low in the polycythemic twin (1.8 and 0.5 multiples of the median). An intrauterine blood transfusion was carried out and this increased the fetal hemoglobin concentration in the anemic twin from 3.5 to 12.5 g/dL. At 29 weeks, delivery by cesarean section was carried out because of evidence from middle cerebral artery peak systolic velocity of recurrence of anemia in one twin and worsening polycythemia in the co-twin; at birth the hemoglobin concentrations were 5.6 and 24.9 g/dL, respectively. Histopathological examination confirmed dichorionicity with no communicating vessels between the two placentas. Conclusions This is the first case of twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy where intrauterine blood transfusion was used to prolong the pregnancy by almost 2 weeks in a “twin anemia polycythemia sequence-like” setting.
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allfields	10.1186/s13256-023-03766-8 doi (DE-627)SPR051398354 (SPR)s13256-023-03766-8-e DE-627 ger DE-627 rakwb eng Jeyaseelan, Tania verfasserin aut Suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Twin anemia polycythemia sequence is a rare complication in monochorionic twin pregnancy. Case presentation We describe a case of dichorionic twin pregnancy presenting with suspected twin anemia polycythemia sequence. A 31-year-old White female, on her third pregnancy, had a routine ultrasound scan at 12 weeks gestation, which demonstrated a dichorionic twin pregnancy with one placenta located in the anterior wall and the other in the posterior wall of the uterus. At 21 weeks, a scan demonstrated a 24% growth discordance between the two fetuses with normal Doppler studies and amniotic fluid. At 27 weeks, one twin showed signs of anemia and the other polycythemia; the fetal middle cerebral artery peak systolic velocity was high in the anemic fetus and low in the polycythemic twin (1.8 and 0.5 multiples of the median). An intrauterine blood transfusion was carried out and this increased the fetal hemoglobin concentration in the anemic twin from 3.5 to 12.5 g/dL. At 29 weeks, delivery by cesarean section was carried out because of evidence from middle cerebral artery peak systolic velocity of recurrence of anemia in one twin and worsening polycythemia in the co-twin; at birth the hemoglobin concentrations were 5.6 and 24.9 g/dL, respectively. Histopathological examination confirmed dichorionicity with no communicating vessels between the two placentas. Conclusions This is the first case of twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy where intrauterine blood transfusion was used to prolong the pregnancy by almost 2 weeks in a “twin anemia polycythemia sequence-like” setting. TAPS (dpeaa)DE-He213 Fetal therapy (dpeaa)DE-He213 Dichorionic twins (dpeaa)DE-He213 Fetal blood transfusion (dpeaa)DE-He213 Shangaris, Panicos (orcid)0000-0003-2750-8405 aut Efthymiou, Athina aut Martin, Linzi aut Story, Lisa aut Nanda, Surabhi aut Gupta, Neelam aut Al-Adnani, Mudher aut Marnerides, Andreas aut Nicolaides, Kypros H. aut Sankaran, Srividhya aut Enthalten in Journal of medical case reports London : BioMed Central, 2007 17(2023), 1 vom: 29. Jan. (DE-627)524231389 (DE-600)2269805-X 1752-1947 nnns volume:17 year:2023 number:1 day:29 month:01 https://dx.doi.org/10.1186/s13256-023-03766-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 17 2023 1 29 01
spelling	10.1186/s13256-023-03766-8 doi (DE-627)SPR051398354 (SPR)s13256-023-03766-8-e DE-627 ger DE-627 rakwb eng Jeyaseelan, Tania verfasserin aut Suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Twin anemia polycythemia sequence is a rare complication in monochorionic twin pregnancy. Case presentation We describe a case of dichorionic twin pregnancy presenting with suspected twin anemia polycythemia sequence. A 31-year-old White female, on her third pregnancy, had a routine ultrasound scan at 12 weeks gestation, which demonstrated a dichorionic twin pregnancy with one placenta located in the anterior wall and the other in the posterior wall of the uterus. At 21 weeks, a scan demonstrated a 24% growth discordance between the two fetuses with normal Doppler studies and amniotic fluid. At 27 weeks, one twin showed signs of anemia and the other polycythemia; the fetal middle cerebral artery peak systolic velocity was high in the anemic fetus and low in the polycythemic twin (1.8 and 0.5 multiples of the median). An intrauterine blood transfusion was carried out and this increased the fetal hemoglobin concentration in the anemic twin from 3.5 to 12.5 g/dL. At 29 weeks, delivery by cesarean section was carried out because of evidence from middle cerebral artery peak systolic velocity of recurrence of anemia in one twin and worsening polycythemia in the co-twin; at birth the hemoglobin concentrations were 5.6 and 24.9 g/dL, respectively. Histopathological examination confirmed dichorionicity with no communicating vessels between the two placentas. Conclusions This is the first case of twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy where intrauterine blood transfusion was used to prolong the pregnancy by almost 2 weeks in a “twin anemia polycythemia sequence-like” setting. TAPS (dpeaa)DE-He213 Fetal therapy (dpeaa)DE-He213 Dichorionic twins (dpeaa)DE-He213 Fetal blood transfusion (dpeaa)DE-He213 Shangaris, Panicos (orcid)0000-0003-2750-8405 aut Efthymiou, Athina aut Martin, Linzi aut Story, Lisa aut Nanda, Surabhi aut Gupta, Neelam aut Al-Adnani, Mudher aut Marnerides, Andreas aut Nicolaides, Kypros H. aut Sankaran, Srividhya aut Enthalten in Journal of medical case reports London : BioMed Central, 2007 17(2023), 1 vom: 29. Jan. (DE-627)524231389 (DE-600)2269805-X 1752-1947 nnns volume:17 year:2023 number:1 day:29 month:01 https://dx.doi.org/10.1186/s13256-023-03766-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 17 2023 1 29 01
allfields_unstemmed	10.1186/s13256-023-03766-8 doi (DE-627)SPR051398354 (SPR)s13256-023-03766-8-e DE-627 ger DE-627 rakwb eng Jeyaseelan, Tania verfasserin aut Suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Twin anemia polycythemia sequence is a rare complication in monochorionic twin pregnancy. Case presentation We describe a case of dichorionic twin pregnancy presenting with suspected twin anemia polycythemia sequence. A 31-year-old White female, on her third pregnancy, had a routine ultrasound scan at 12 weeks gestation, which demonstrated a dichorionic twin pregnancy with one placenta located in the anterior wall and the other in the posterior wall of the uterus. At 21 weeks, a scan demonstrated a 24% growth discordance between the two fetuses with normal Doppler studies and amniotic fluid. At 27 weeks, one twin showed signs of anemia and the other polycythemia; the fetal middle cerebral artery peak systolic velocity was high in the anemic fetus and low in the polycythemic twin (1.8 and 0.5 multiples of the median). An intrauterine blood transfusion was carried out and this increased the fetal hemoglobin concentration in the anemic twin from 3.5 to 12.5 g/dL. At 29 weeks, delivery by cesarean section was carried out because of evidence from middle cerebral artery peak systolic velocity of recurrence of anemia in one twin and worsening polycythemia in the co-twin; at birth the hemoglobin concentrations were 5.6 and 24.9 g/dL, respectively. Histopathological examination confirmed dichorionicity with no communicating vessels between the two placentas. Conclusions This is the first case of twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy where intrauterine blood transfusion was used to prolong the pregnancy by almost 2 weeks in a “twin anemia polycythemia sequence-like” setting. TAPS (dpeaa)DE-He213 Fetal therapy (dpeaa)DE-He213 Dichorionic twins (dpeaa)DE-He213 Fetal blood transfusion (dpeaa)DE-He213 Shangaris, Panicos (orcid)0000-0003-2750-8405 aut Efthymiou, Athina aut Martin, Linzi aut Story, Lisa aut Nanda, Surabhi aut Gupta, Neelam aut Al-Adnani, Mudher aut Marnerides, Andreas aut Nicolaides, Kypros H. aut Sankaran, Srividhya aut Enthalten in Journal of medical case reports London : BioMed Central, 2007 17(2023), 1 vom: 29. Jan. (DE-627)524231389 (DE-600)2269805-X 1752-1947 nnns volume:17 year:2023 number:1 day:29 month:01 https://dx.doi.org/10.1186/s13256-023-03766-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 17 2023 1 29 01
allfieldsGer	10.1186/s13256-023-03766-8 doi (DE-627)SPR051398354 (SPR)s13256-023-03766-8-e DE-627 ger DE-627 rakwb eng Jeyaseelan, Tania verfasserin aut Suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Twin anemia polycythemia sequence is a rare complication in monochorionic twin pregnancy. Case presentation We describe a case of dichorionic twin pregnancy presenting with suspected twin anemia polycythemia sequence. A 31-year-old White female, on her third pregnancy, had a routine ultrasound scan at 12 weeks gestation, which demonstrated a dichorionic twin pregnancy with one placenta located in the anterior wall and the other in the posterior wall of the uterus. At 21 weeks, a scan demonstrated a 24% growth discordance between the two fetuses with normal Doppler studies and amniotic fluid. At 27 weeks, one twin showed signs of anemia and the other polycythemia; the fetal middle cerebral artery peak systolic velocity was high in the anemic fetus and low in the polycythemic twin (1.8 and 0.5 multiples of the median). An intrauterine blood transfusion was carried out and this increased the fetal hemoglobin concentration in the anemic twin from 3.5 to 12.5 g/dL. At 29 weeks, delivery by cesarean section was carried out because of evidence from middle cerebral artery peak systolic velocity of recurrence of anemia in one twin and worsening polycythemia in the co-twin; at birth the hemoglobin concentrations were 5.6 and 24.9 g/dL, respectively. Histopathological examination confirmed dichorionicity with no communicating vessels between the two placentas. Conclusions This is the first case of twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy where intrauterine blood transfusion was used to prolong the pregnancy by almost 2 weeks in a “twin anemia polycythemia sequence-like” setting. TAPS (dpeaa)DE-He213 Fetal therapy (dpeaa)DE-He213 Dichorionic twins (dpeaa)DE-He213 Fetal blood transfusion (dpeaa)DE-He213 Shangaris, Panicos (orcid)0000-0003-2750-8405 aut Efthymiou, Athina aut Martin, Linzi aut Story, Lisa aut Nanda, Surabhi aut Gupta, Neelam aut Al-Adnani, Mudher aut Marnerides, Andreas aut Nicolaides, Kypros H. aut Sankaran, Srividhya aut Enthalten in Journal of medical case reports London : BioMed Central, 2007 17(2023), 1 vom: 29. Jan. (DE-627)524231389 (DE-600)2269805-X 1752-1947 nnns volume:17 year:2023 number:1 day:29 month:01 https://dx.doi.org/10.1186/s13256-023-03766-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 17 2023 1 29 01
allfieldsSound	10.1186/s13256-023-03766-8 doi (DE-627)SPR051398354 (SPR)s13256-023-03766-8-e DE-627 ger DE-627 rakwb eng Jeyaseelan, Tania verfasserin aut Suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Twin anemia polycythemia sequence is a rare complication in monochorionic twin pregnancy. Case presentation We describe a case of dichorionic twin pregnancy presenting with suspected twin anemia polycythemia sequence. A 31-year-old White female, on her third pregnancy, had a routine ultrasound scan at 12 weeks gestation, which demonstrated a dichorionic twin pregnancy with one placenta located in the anterior wall and the other in the posterior wall of the uterus. At 21 weeks, a scan demonstrated a 24% growth discordance between the two fetuses with normal Doppler studies and amniotic fluid. At 27 weeks, one twin showed signs of anemia and the other polycythemia; the fetal middle cerebral artery peak systolic velocity was high in the anemic fetus and low in the polycythemic twin (1.8 and 0.5 multiples of the median). An intrauterine blood transfusion was carried out and this increased the fetal hemoglobin concentration in the anemic twin from 3.5 to 12.5 g/dL. At 29 weeks, delivery by cesarean section was carried out because of evidence from middle cerebral artery peak systolic velocity of recurrence of anemia in one twin and worsening polycythemia in the co-twin; at birth the hemoglobin concentrations were 5.6 and 24.9 g/dL, respectively. Histopathological examination confirmed dichorionicity with no communicating vessels between the two placentas. Conclusions This is the first case of twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy where intrauterine blood transfusion was used to prolong the pregnancy by almost 2 weeks in a “twin anemia polycythemia sequence-like” setting. TAPS (dpeaa)DE-He213 Fetal therapy (dpeaa)DE-He213 Dichorionic twins (dpeaa)DE-He213 Fetal blood transfusion (dpeaa)DE-He213 Shangaris, Panicos (orcid)0000-0003-2750-8405 aut Efthymiou, Athina aut Martin, Linzi aut Story, Lisa aut Nanda, Surabhi aut Gupta, Neelam aut Al-Adnani, Mudher aut Marnerides, Andreas aut Nicolaides, Kypros H. aut Sankaran, Srividhya aut Enthalten in Journal of medical case reports London : BioMed Central, 2007 17(2023), 1 vom: 29. Jan. (DE-627)524231389 (DE-600)2269805-X 1752-1947 nnns volume:17 year:2023 number:1 day:29 month:01 https://dx.doi.org/10.1186/s13256-023-03766-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 17 2023 1 29 01
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spellingShingle	Jeyaseelan, Tania misc TAPS misc Fetal therapy misc Dichorionic twins misc Fetal blood transfusion Suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report
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topic_title	Suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report TAPS (dpeaa)DE-He213 Fetal therapy (dpeaa)DE-He213 Dichorionic twins (dpeaa)DE-He213 Fetal blood transfusion (dpeaa)DE-He213
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title	Suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report
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title_full	Suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report
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author_browse	Jeyaseelan, Tania Shangaris, Panicos Efthymiou, Athina Martin, Linzi Story, Lisa Nanda, Surabhi Gupta, Neelam Al-Adnani, Mudher Marnerides, Andreas Nicolaides, Kypros H. Sankaran, Srividhya
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title_sort	suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report
title_auth	Suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report
abstract	Background Twin anemia polycythemia sequence is a rare complication in monochorionic twin pregnancy. Case presentation We describe a case of dichorionic twin pregnancy presenting with suspected twin anemia polycythemia sequence. A 31-year-old White female, on her third pregnancy, had a routine ultrasound scan at 12 weeks gestation, which demonstrated a dichorionic twin pregnancy with one placenta located in the anterior wall and the other in the posterior wall of the uterus. At 21 weeks, a scan demonstrated a 24% growth discordance between the two fetuses with normal Doppler studies and amniotic fluid. At 27 weeks, one twin showed signs of anemia and the other polycythemia; the fetal middle cerebral artery peak systolic velocity was high in the anemic fetus and low in the polycythemic twin (1.8 and 0.5 multiples of the median). An intrauterine blood transfusion was carried out and this increased the fetal hemoglobin concentration in the anemic twin from 3.5 to 12.5 g/dL. At 29 weeks, delivery by cesarean section was carried out because of evidence from middle cerebral artery peak systolic velocity of recurrence of anemia in one twin and worsening polycythemia in the co-twin; at birth the hemoglobin concentrations were 5.6 and 24.9 g/dL, respectively. Histopathological examination confirmed dichorionicity with no communicating vessels between the two placentas. Conclusions This is the first case of twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy where intrauterine blood transfusion was used to prolong the pregnancy by almost 2 weeks in a “twin anemia polycythemia sequence-like” setting. © The Author(s) 2023
abstractGer	Background Twin anemia polycythemia sequence is a rare complication in monochorionic twin pregnancy. Case presentation We describe a case of dichorionic twin pregnancy presenting with suspected twin anemia polycythemia sequence. A 31-year-old White female, on her third pregnancy, had a routine ultrasound scan at 12 weeks gestation, which demonstrated a dichorionic twin pregnancy with one placenta located in the anterior wall and the other in the posterior wall of the uterus. At 21 weeks, a scan demonstrated a 24% growth discordance between the two fetuses with normal Doppler studies and amniotic fluid. At 27 weeks, one twin showed signs of anemia and the other polycythemia; the fetal middle cerebral artery peak systolic velocity was high in the anemic fetus and low in the polycythemic twin (1.8 and 0.5 multiples of the median). An intrauterine blood transfusion was carried out and this increased the fetal hemoglobin concentration in the anemic twin from 3.5 to 12.5 g/dL. At 29 weeks, delivery by cesarean section was carried out because of evidence from middle cerebral artery peak systolic velocity of recurrence of anemia in one twin and worsening polycythemia in the co-twin; at birth the hemoglobin concentrations were 5.6 and 24.9 g/dL, respectively. Histopathological examination confirmed dichorionicity with no communicating vessels between the two placentas. Conclusions This is the first case of twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy where intrauterine blood transfusion was used to prolong the pregnancy by almost 2 weeks in a “twin anemia polycythemia sequence-like” setting. © The Author(s) 2023
abstract_unstemmed	Background Twin anemia polycythemia sequence is a rare complication in monochorionic twin pregnancy. Case presentation We describe a case of dichorionic twin pregnancy presenting with suspected twin anemia polycythemia sequence. A 31-year-old White female, on her third pregnancy, had a routine ultrasound scan at 12 weeks gestation, which demonstrated a dichorionic twin pregnancy with one placenta located in the anterior wall and the other in the posterior wall of the uterus. At 21 weeks, a scan demonstrated a 24% growth discordance between the two fetuses with normal Doppler studies and amniotic fluid. At 27 weeks, one twin showed signs of anemia and the other polycythemia; the fetal middle cerebral artery peak systolic velocity was high in the anemic fetus and low in the polycythemic twin (1.8 and 0.5 multiples of the median). An intrauterine blood transfusion was carried out and this increased the fetal hemoglobin concentration in the anemic twin from 3.5 to 12.5 g/dL. At 29 weeks, delivery by cesarean section was carried out because of evidence from middle cerebral artery peak systolic velocity of recurrence of anemia in one twin and worsening polycythemia in the co-twin; at birth the hemoglobin concentrations were 5.6 and 24.9 g/dL, respectively. Histopathological examination confirmed dichorionicity with no communicating vessels between the two placentas. Conclusions This is the first case of twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy where intrauterine blood transfusion was used to prolong the pregnancy by almost 2 weeks in a “twin anemia polycythemia sequence-like” setting. © The Author(s) 2023
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title_short	Suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report
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author2	Shangaris, Panicos Efthymiou, Athina Martin, Linzi Story, Lisa Nanda, Surabhi Gupta, Neelam Al-Adnani, Mudher Marnerides, Andreas Nicolaides, Kypros H. Sankaran, Srividhya
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Case presentation We describe a case of dichorionic twin pregnancy presenting with suspected twin anemia polycythemia sequence. A 31-year-old White female, on her third pregnancy, had a routine ultrasound scan at 12 weeks gestation, which demonstrated a dichorionic twin pregnancy with one placenta located in the anterior wall and the other in the posterior wall of the uterus. At 21 weeks, a scan demonstrated a 24% growth discordance between the two fetuses with normal Doppler studies and amniotic fluid. At 27 weeks, one twin showed signs of anemia and the other polycythemia; the fetal middle cerebral artery peak systolic velocity was high in the anemic fetus and low in the polycythemic twin (1.8 and 0.5 multiples of the median). An intrauterine blood transfusion was carried out and this increased the fetal hemoglobin concentration in the anemic twin from 3.5 to 12.5 g/dL. At 29 weeks, delivery by cesarean section was carried out because of evidence from middle cerebral artery peak systolic velocity of recurrence of anemia in one twin and worsening polycythemia in the co-twin; at birth the hemoglobin concentrations were 5.6 and 24.9 g/dL, respectively. Histopathological examination confirmed dichorionicity with no communicating vessels between the two placentas. Conclusions This is the first case of twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy where intrauterine blood transfusion was used to prolong the pregnancy by almost 2 weeks in a “twin anemia polycythemia sequence-like” setting.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">TAPS</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Fetal therapy</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Dichorionic twins</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Fetal blood transfusion</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Shangaris, Panicos</subfield><subfield code="0">(orcid)0000-0003-2750-8405</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Efthymiou, Athina</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Martin, Linzi</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Story, Lisa</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Nanda, Surabhi</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Gupta, Neelam</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Al-Adnani, Mudher</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Marnerides, Andreas</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Nicolaides, Kypros H.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Sankaran, Srividhya</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">Journal of medical case reports</subfield><subfield code="d">London : BioMed Central, 2007</subfield><subfield code="g">17(2023), 1 vom: 29. 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Suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report

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