Complex Fetal Care: Twin Anemia Polycythemia Sequence

Twin anemia polycythemia sequence is a rare condition in monochorionic twin pregnancies that has only recently been described. It can occur spontaneously or as a result of fetoscopic laser surgery for twin to twin transfusion syndrome. The size of the placental connections and the flow of blood between tiny anastomoses allow for chronic changes in the hemodynamic states of each fetus. The chronic nature of the pathophysiology leads to reticulocytosis in the donor twin and limits the fluid-level discrepancies between amniotic sacs, which differentiates it from twin to twin transfusion syndrome, which is thought to be an acute process. Several in utero procedures have been described to treat this condition; however, because of the rarity of the condition, data are limited. Postnatal treatment includes packed red blood cell transfusion for the donor twin and partial exchange transfusion for the recipient twin, along with standard medical neonatal care. Long-term outcomes data are limited; however, one study revealed normal neurodevelopment in a small cohort of patients.
Source: NeoReviews recent issues - Category: Pediatrics Authors: Tags: Pediatric Drug Labeling Update Articles Source Type: news