Multidisciplinary Approach in the Diagnosis and Treatment of Twin Anemia Polycythemia Sequence in Monochorionic Twin Pregnancies: Case Report
Abstract
:1. Introduction
2. Detailed Case Description
3. Discussion
3.1. Prenatal Diagnosis
3.2. Postnatal Diagnosis
3.3. Management
3.4. Prognosis
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Recipient | Donor | |
---|---|---|
date of birth | 29 February 2024 | 29 February 2024 |
weight | 1700 gr | 1450gr |
Apgar | 8/9 | 6/9 |
pH | 7.16 | 7.16 |
hemoglobin | 24 g/dL | 6.5 g/dL |
hematocrit | 69.3% | 22% |
reticulocyte count | 272 cells/µL | 265 cells/µL |
reticulocyte percentage | 4.6% | 16.2% |
Stage | Classical Classification Criteria | Delta Value-Based Classification Criteria |
---|---|---|
Stage I | ACM-PVS donor > 1.5 MoM, recipient < 1 MoM. | Delta ACM-PVS > 0.5 MoM. |
Stage II | ACM-PVS donor > 1.7 MoM, recipient < 0.8 MoM. | Delta ACM-PVS > 0.7 MoM. |
Stage III | Stage I or II associated with donor cardiac compromise *. | Stage I or II associated with donor cardiac compromise. |
Stage IV | Fetal hydrops donor. | Fetal hydrops donor. |
Stage V | Death | Death |
<28 weeks | Stage 1 | Expectant management |
Stage ≥ 2 | Laser treatment | |
28–32 weeks | Stage 1 | Expectant management |
Stage 2 WITHOUT progression | Laser treatment | |
Stage 2 WITH progression | Intrauterine transfusion | |
Stage > 3 | Intrauterine transfusion | |
>32 weeks | Stage 1 | Expectant management |
Stage 2 WITHOUT progression | Expectant management | |
Stage 2 WITH progression | Terminate pregnancy | |
Stage > 3 | Terminate pregnancy |
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Fortún Agud, M.; Marfil González, M.; Monis Rodríguez, S.; Suarez Arana, M.; Blasco Alonso, M.; Jimenez Lopez, J.; Narbona Arias, I. Multidisciplinary Approach in the Diagnosis and Treatment of Twin Anemia Polycythemia Sequence in Monochorionic Twin Pregnancies: Case Report. Life 2024, 14, 1071. https://doi.org/10.3390/life14091071
Fortún Agud M, Marfil González M, Monis Rodríguez S, Suarez Arana M, Blasco Alonso M, Jimenez Lopez J, Narbona Arias I. Multidisciplinary Approach in the Diagnosis and Treatment of Twin Anemia Polycythemia Sequence in Monochorionic Twin Pregnancies: Case Report. Life. 2024; 14(9):1071. https://doi.org/10.3390/life14091071
Chicago/Turabian StyleFortún Agud, Marina, María Marfil González, Susana Monis Rodríguez, Maria Suarez Arana, Marta Blasco Alonso, Jesus Jimenez Lopez, and Isidoro Narbona Arias. 2024. "Multidisciplinary Approach in the Diagnosis and Treatment of Twin Anemia Polycythemia Sequence in Monochorionic Twin Pregnancies: Case Report" Life 14, no. 9: 1071. https://doi.org/10.3390/life14091071