title: Evaluation of the Utility of in utero Treatment of Twin Anemia-Polycythemia Sequence.
abstract: OBJECTIVE
  The aim of this study is to evaluate the interest in the in utero treatment of twin anemia-polycythemia sequence (TAPS).
  
  
  METHODS
  The obstetrical and neonatal data on all cases of TAPS followed up in our institution between 2006 and 2013 were reviewed. Statistical analyses were conducted using Bayesian methods.
  
  
  RESULTS
  Twenty cases of TAPS were included. Laser therapy or intrauterine transfusion (IUT) was performed on the donor twin in 9 cases. Eleven cases were included in the 'nontreated' group (managed expectantly or diagnosed at birth). The gestational age at diagnosis was lower in the group with treated TAPS [difference (diff) = -22.20 days (-57.13, 14.28), probability (Pr) (diff >0) = 10.6%]. The rate of preterm premature rupture of membranes was higher in the group with treated TAPS [diff = 22.5% (-14, 57), Pr (diff >0) = 89%], but overall mortality was similar. The interval between diagnosis and delivery was longer [diff = 44.37 days (9.41, 77.90), Pr (diff >0) = 99.2%], the TAPS resolution rate was higher [diff = 49.9% (12, 81), Pr (diff >0) = 99.4%], and the neonatal transfusion rate was lower [diff = -30.5% (-60, 0), Pr (diff >0) = 2.6%] in the treated group.
  
  
  CONCLUSIONS
  In utero treatment for TAPS is associated with a higher resolution rate of TAPS and a longer time between diagnosis and birth, but overall mortality is the same as with expectant management.
authors: Department of Obstetrics and Gynecology, Strasbourg University Teaching Hospitals, Strasbourg, France.
authors: Nicolas
authors: N
authors: Sananès
authors: Marine
authors: M
authors: Veujoz
authors: Francois
authors: F
authors: Severac
authors: Maël
authors: M
authors: Barthoulot
authors: Nicolas
authors: N
authors: Meyer
authors: Anne-Sophie
authors: AS
authors: Weingertner
authors: Monique
authors: M
authors: Kohler
authors: Fernando
authors: F
authors: Guerra
authors: Adrien
authors: A
authors: Gaudineau
authors: Israël
authors: I
authors: Nisand
authors: Romain
authors: R
authors: Favre
mesh_terms: D000328:Adult; D000740:Anemia / Q000601:surgery / Q000628:therapy*; D001805:Blood Transfusion, Intrauterine / Q000379:methods*; D005260:Female; D005330:Fetofetal Transfusion / Q000601:surgery / Q000628:therapy*; D005865:Gestational Age; D006801:Humans; D017075:Laser Coagulation; D011086:Polycythemia / Q000601:surgery / Q000628:therapy*; D011247:Pregnancy; D016896:Treatment Outcome