Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2026
Rheology of Twin Anemia-Polycythemia Sequence: Insights from Hemoglobin Electrophoresis - A Case Report.
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Khan Shane, Ogilby Todd, Buyukdere Hakan, Fung-Kee-Fung Karen
Аннотация
INTRODUCTION: Twin anemia-polycythemia sequence (TAPS) is a recognized complication of monochorionic (MC) twins due to abnormal placental vasculature. Determining the rheology involved within the abnormal placental vasculature may help in identifying the optimum treatment option.
CASE PRESENTATION: We describe a case of TAPS which was treated via intrauterine transfusions (IUTs) with partial exchange transfusions in which additional hemoglobin electrophoresis (HbEp) testing was performed on cordocentesis samples taken before and after IUTs and partial exchange transfusions for the donor and recipient twin, respectively. The aim was to assess the flow dynamics from the donor to recipient twin. No differences in hemoglobin A (HbA) were found in the polycythemic twin after 30 min of IUT of the anemic co-twin but within 13 days of first transfusion, greater than a 3-fold rise in HbA was apparent. Within 5 days of second treatment a further 9% rise in HbA was encountered.
CONCLUSION: The use of HbEp testing in this case provided preliminary insights into the fluid dynamics involved in TAPS; however, further studies are required to achieve better understanding.
CASE PRESENTATION: We describe a case of TAPS which was treated via intrauterine transfusions (IUTs) with partial exchange transfusions in which additional hemoglobin electrophoresis (HbEp) testing was performed on cordocentesis samples taken before and after IUTs and partial exchange transfusions for the donor and recipient twin, respectively. The aim was to assess the flow dynamics from the donor to recipient twin. No differences in hemoglobin A (HbA) were found in the polycythemic twin after 30 min of IUT of the anemic co-twin but within 13 days of first transfusion, greater than a 3-fold rise in HbA was apparent. Within 5 days of second treatment a further 9% rise in HbA was encountered.
CONCLUSION: The use of HbEp testing in this case provided preliminary insights into the fluid dynamics involved in TAPS; however, further studies are required to achieve better understanding.