{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T22:24:13Z","timestamp":1768343053989,"version":"3.49.0"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the prevalence of three additional ultrasound markers, placental dichotomy, cardiomegaly and \u2018starry\u2010sky\u2019 liver, in monochorionic twin pregnancy with twin anemia\u2013polycythemia sequence (TAPS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All monochorionic twin pregnancies, diagnosed antenatally with TAPS at our center between 2006 and 2019, were reviewed retrospectively for the presence of placental dichotomy, cardiomegaly in the donor twin and a starry\u2010sky liver in the recipient twin. TAPS was diagnosed based on delta middle cerebral artery (MCA) peak systolic velocity (PSV) &gt;\u20090.5 multiples of the median. The primary outcome was the prevalence of placental dichotomy, cardiomegaly, starry\u2010sky liver and at least one of these markers in both spontaneous and post\u2010laser TAPS. The secondary outcome was the prevalence of these ultrasound markers according to the antenatal stage of TAPS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 91 monochorionic twin pregnancies with TAPS were eligible for analysis. Placental dichotomy was observed in 44% (40\/91) of TAPS cases. A total of 70% (64\/91) of the TAPS donors developed cardiomegaly and a starry\u2010sky liver was identified in 66% (53\/80) of the TAPS recipients. The prevalence of cardiomegaly and starry\u2010sky liver was roughly comparable between spontaneous and post\u2010laser TAPS (69% (33\/48) <jats:italic>vs<\/jats:italic> 72% (31\/43) and 64% (25\/39) <jats:italic>vs<\/jats:italic> 68% (28\/41), respectively). Pregnancies with spontaneous TAPS showed a higher prevalence of placental dichotomy compared with post\u2010laser TAPS (63% (30\/48) <jats:italic>vs<\/jats:italic> 23% (10\/43)). At least one of the three ultrasound markers was detected in 86% (78\/91) of TAPS cases, meaning that 14% (13\/91) of cases presented solely with discordant MCA\u2010PSV values. There was a trend towards increased prevalence of all three ultrasound markers with increasing antenatal TAPS stage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Placental dichotomy, fetal cardiomegaly and a starry\u2010sky liver are commonly found in TAPS pregnancy. Investigating the presence of these ultrasound markers can be of additional help in improving antenatal detection of TAPS in monochorionic twin pregnancy. \u00a9 2019 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.21948","type":"journal-article","created":{"date-parts":[[2019,12,19]],"date-time":"2019-12-19T19:49:16Z","timestamp":1576784956000},"page":"395-399","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Prevalence of placental dichotomy, fetal cardiomegaly and starry\u2010sky liver in twin anemia\u2013polycythemia sequence"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2078-2295","authenticated-orcid":false,"given":"L. S. A.","family":"Tollenaar","sequence":"first","affiliation":[{"name":"Division of Fetal Medicine, Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Lopriore","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. M.","family":"Middeldorp","sequence":"additional","affiliation":[{"name":"Division of Fetal Medicine, Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. J. C. M.","family":"Klumper","sequence":"additional","affiliation":[{"name":"Division of Fetal Medicine, Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0443-1997","authenticated-orcid":false,"given":"M. C.","family":"Haak","sequence":"additional","affiliation":[{"name":"Division of Fetal Medicine, Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Oepkes","sequence":"additional","affiliation":[{"name":"Division of Fetal Medicine, Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Slaghekke","sequence":"additional","affiliation":[{"name":"Division of Fetal Medicine, Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2006.01.010"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.05.012"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.07.046"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2491"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20096"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30388-1"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2009.28.3.375"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13276"},{"key":"e_1_2_6_10_1","first-page":"471","article-title":"Diagnosis and management of heart failure in the fetus","volume":"64","author":"Davey B","year":"2012","journal-title":"Minerva Pediatr"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17535"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200001063420102"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13387"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4371"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000442154"},{"key":"e_1_2_6_16_1","volume-title":"Starry Sky Appearance (ultrasound)","author":"Gaillard F","year":"2020"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.21948","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.21948","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.21948","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.21948","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T09:43:47Z","timestamp":1693302227000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.21948"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1002\/uog.21948"],"URL":"https:\/\/doi.org\/10.1002\/uog.21948","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9]]},"assertion":[{"value":"2019-08-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}