title: A case report of a successful monochorionic diamniotic twin pregnancy in a patient affected by sickle cell disease treated with erythrocytapheresis.
abstract: We describe a monochorionic diamniotic twin pregnancy in a 28-year-old woman with a severe form of sickle cell disease periodically treated with erythrocytapheresis (EA). During this high risk pregnancy, two sessions of EA were performed without complications, and pain control and fetal growth were optimal. Delivery was carried out by emergency cesarean section at 29(+3) weeks' gestation due to initial fetal distress following twin-to-twin transfusion. There were no significant complications for the newborn twins and the post-partum course was regular. The patient underwent a further EA 7 weeks after surgery. Close collaboration between obstetricians and hematologists with careful maternal-fetal monitoring and prophylactic EA during pregnancy led to a favorable outcome despite a low maternal body weight, a twin pregnancy, and a severe form of sickle cell disease.
authors.affiliation: Department of Pediatrics, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Motta
authors.forename: Paolo
authors.initials: P
authors.lastname: Perseghin
authors.forename: Sara
authors.initials: S
authors.lastname: Consonni
authors.forename: Anna L
authors.initials: AL
authors.lastname: Regalia
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Masera
mesh_terms: D000328:Adult; D000650:Amnion; D000755:Anemia, Sickle Cell / Q000628:therapy*; D002585:Cesarean Section; D002823:Chorion; D016238:Cytapheresis / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods; D004912:Erythrocytes; D005260:Female; D005330:Fetofetal Transfusion; D005500:Follow-Up Studies; D006801:Humans; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000628:therapy*; D018566:Pregnancy, High-Risk; D011272:Pregnancy, Multiple; D016896:Treatment Outcome; D014427:Twins