{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T08:52:19Z","timestamp":1784364739191,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,10,5]],"date-time":"2016-10-05T00:00:00Z","timestamp":1475625600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The antenatal diagnosis of twin anemia\u2013polycythemia sequence (<jats:styled-content style=\"fixed-case\">TAPS<\/jats:styled-content>) in monochorionic\u2013diamniotic (<jats:styled-content style=\"fixed-case\">MCDA<\/jats:styled-content>) twin pregnancies is based on elevated peak systolic velocity in the middle cerebral artery (<jats:styled-content style=\"fixed-case\">MCA\u2010PSV<\/jats:styled-content>) in the donor twin and decreased <jats:styled-content style=\"fixed-case\">MCA\u2010PSV<\/jats:styled-content> in the recipient twin. However, the association between these parameters and polycythemia has not yet been established. The aim of this study was to determine whether <jats:styled-content style=\"fixed-case\">MCA\u2010PSV<\/jats:styled-content> can predict polycythemia in <jats:styled-content style=\"fixed-case\">MCDA<\/jats:styled-content> pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective cohort study of <jats:styled-content style=\"fixed-case\">MCDA<\/jats:styled-content> pregnancies recruited at 14\u201318 weeks' gestation from a single tertiary care center between January 2011 and June 2014. Fetal <jats:styled-content style=\"fixed-case\">MCA<\/jats:styled-content> Doppler waveforms were recorded every 2 weeks from 18 weeks' gestation until delivery. Only those with an <jats:styled-content style=\"fixed-case\">MCA\u2010PSV<\/jats:styled-content> measurement within 1 week of delivery were included in the analysis. Neonatal hematocrit level was determined in all twins from venous blood obtained within 4\u2009h of delivery. Polycythemia was defined as a hematocrit of &gt;\u200965%, and anemia as a hematocrit of &lt;\u200945%. <jats:styled-content style=\"fixed-case\">TAPS<\/jats:styled-content> was diagnosed when an intertwin hemoglobin difference of &gt;\u20098\u2009g\/<jats:styled-content style=\"fixed-case\">dL<\/jats:styled-content> and reticulocyte count ratio of &gt;\u20091.7 were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 162 <jats:styled-content style=\"fixed-case\">MCDA<\/jats:styled-content> pregnancies followed during the study period, 69 had an <jats:styled-content style=\"fixed-case\">MCA\u2010PSV<\/jats:styled-content> measurement within 1 week of delivery and were included in the study. Twenty\u2010five neonates were diagnosed with polycythemia and nine twin pairs met the criteria for <jats:styled-content style=\"fixed-case\">TAPS<\/jats:styled-content>. In a pooled analysis, <jats:styled-content style=\"fixed-case\">MCA\u2010PSV<\/jats:styled-content> was negatively correlated with neonatal hematocrit (<jats:italic>P<\/jats:italic> = 0.017, <jats:italic>r<\/jats:italic> = \u22120.215) and was significantly higher in anemic fetuses than in normal controls (1.15 multiples of the median (<jats:styled-content style=\"fixed-case\">MoM<\/jats:styled-content>) <jats:italic>vs<\/jats:italic> 1.02 <jats:styled-content style=\"fixed-case\">MoM<\/jats:styled-content>, respectively; <jats:italic>P<\/jats:italic> = 0.001). However, <jats:styled-content style=\"fixed-case\">MCA\u2010PSV<\/jats:styled-content> was similar among polycythemic and normal fetuses (0.95 <jats:styled-content style=\"fixed-case\">MoM<\/jats:styled-content> <jats:italic>vs<\/jats:italic> 1.02 <jats:styled-content style=\"fixed-case\">MoM<\/jats:styled-content>, respectively; <jats:italic>P<\/jats:italic> = 0.47). Intertwin difference in <jats:styled-content style=\"fixed-case\">MCA\u2010PSV<\/jats:styled-content> (delta <jats:styled-content style=\"fixed-case\">MCA\u2010PSV<\/jats:styled-content>) was positively correlated with intertwin hematocrit difference (<jats:italic>P<\/jats:italic> = 0.002, <jats:italic>r<\/jats:italic> = 0.394). Moreover, twin pregnancies with an intertwin hematocrit difference of &gt;\u200924% had a significantly greater delta <jats:styled-content style=\"fixed-case\">MCA\u2010PSV<\/jats:styled-content> than did those with an intertwin hematocrit difference of \u2264\u200924% (delta <jats:styled-content style=\"fixed-case\">MCA\u2010PSV<\/jats:styled-content>, 19 <jats:italic>vs<\/jats:italic> 5\u2009cm\/s; <jats:italic>P<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">MCA\u2010PSV<\/jats:styled-content> is not significantly decreased in polycythemic <jats:styled-content style=\"fixed-case\">MCDA<\/jats:styled-content> twins. However, delta <jats:styled-content style=\"fixed-case\">MCA\u2010PSV<\/jats:styled-content> is associated with a large intertwin difference in hematocrit, and its use may be better than conventional methods for the risk assessment of <jats:styled-content style=\"fixed-case\">TAPS<\/jats:styled-content>. Copyright \u00a9 2015 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.15838","type":"journal-article","created":{"date-parts":[[2015,12,11]],"date-time":"2015-12-11T08:49:04Z","timestamp":1449823744000},"page":"470-475","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Can middle cerebral artery peak systolic velocity predict polycythemia in monochorionic\u2013diamniotic twins? Evidence from a prospective cohort study"],"prefix":"10.1002","volume":"48","author":[{"given":"M.","family":"Fishel\u2010Bartal","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sheba Medical Center, Tel\u2010Hashomer, Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Weisz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sheba Medical Center, Tel\u2010Hashomer, Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Mazaki\u2010Tovi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sheba Medical Center, Tel\u2010Hashomer, Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Ashwal","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sheba Medical Center, Tel\u2010Hashomer, Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Chayen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sheba Medical Center, Tel\u2010Hashomer, Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Lipitz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sheba Medical Center, Tel\u2010Hashomer, Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Yinon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sheba Medical Center, Tel\u2010Hashomer, Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,10,5]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(00)70233-X"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.05.009"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(199809)18:9<941::AID-PD427>3.0.CO;2-G"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000263622"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.04.022"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318187e1ff"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2006.01.010"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.03.050"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12641"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2491"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13387"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.08.069"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.07.046"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000336227"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000304512"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4545"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2453"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200001063420102"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6436"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14782"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2011.02305.x"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.02.032"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6334"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.06.005"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12337"}],"container-title":["Ultrasound in Obstetrics &amp; 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