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Perinatal outcomes of pregnancies complicated by twin anemia–polycythemia sequence: A systematic review and meta‐analysis

Ultrasound in Obstetrics & Gynecology Jan 20, 2021

Giorgione V, D'Antonio F, Manji A, et al. - Researchers aimed at describing the perinatal outcome in monochorionic diamniotic (MC) twin pregnancies complicated by twin anemia polycythemia sequence (TAPS). They performed a search in Medline, Embase and Cochrane Library databases with following inclusion criteria: non‐anomalous MCDA twin pregnancies with a diagnosis of TAPS. Assessment of spontaneous and post‐laser TAPS (506 pregnancies) revealed occurrence of IUD in 5.32% of spontaneous and in 10.2% of post‐laser TAPS, while for NND, the corresponding figures were 4.0% and 9.2%. In total, 29.3% of twins after spontaneous and 33.3% after post‐laser TAPS had occurrence of severe neonatal morbidity, while the corresponding figures for severe neurological morbidity were 4.0% and 11.1% respectively. All cases with post‐laser TAPS and 86.3% of pregnancies with spontaneous TAPS were complicated by PTB. Both groups more frequently had iatrogenic PTB than the spontaneous PTB. Although they were unable to perform a direct comparison, the results here indicate a better prognosis for spontaneous TAPS relative to post Laser TAPS. Comparison of different management options for TAPS (expectant, laser, intra‐uterine transfusion and selective reduction) revealed no differences in terms of mortality and morbidity. Based on the findings, they suggest undertaking an individualized prenatal management, taking into account the severity of TAPS and gestational age.

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