{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:22:10Z","timestamp":1760145730003,"version":"build-2065373602"},"reference-count":11,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T00:00:00Z","timestamp":1724716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Twin anemia\u2013polycythemia sequence (TAPS) in monochorionic twin pregnancies is a potentially serious complication caused by unidirectional vascular anastomoses in the placenta, resulting in one anemic donor twin and one polycythemic recipient twin. Diagnosis of this condition is achieved through Doppler ultrasound assessment of the difference between the MoM of the peak systolic velocity of the middle cerebral artery between the twins, establishing the diagnosis with a delta value &gt;0.5 MoM. Management of this situation is individualized and may include intrauterine transfusions, intrauterine laser treatment, and expectant management through ultrasound monitoring of both fetuses to prevent complications. In severe cases, pregnancy termination may be necessary. It is essential that these pregnancies are managed by a multidisciplinary team of professionals, including obstetricians specialized in fetal medicine and neonatologists, to ensure the best possible outcome for both the mother and the fetuses. Early detection and treatment are crucial in the management of pregnancies complicated by twin anemia\u2013polycythemia sequence. The main objective of this article is to conduct a review of the existing literature on the anemia\u2013polycythemia sequence in monochorionic pregnancies, emphasizing the exceptional nature of the presented case due to its spontaneous occurrence, which has a very low prevalence compared to post-laser TAPS cases. It also discusses the different treatment options, highlighting the importance of expectant management and individualization in each case.<\/jats:p>","DOI":"10.3390\/life14091071","type":"journal-article","created":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T06:19:01Z","timestamp":1724739541000},"page":"1071","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multidisciplinary Approach in the Diagnosis and Treatment of Twin Anemia Polycythemia Sequence in Monochorionic Twin Pregnancies: Case Report"],"prefix":"10.3390","volume":"14","author":[{"given":"Marina","family":"Fort\u00fan Agud","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, Materno-Infantil Hospital Regional Universitaria M\u00e1laga, Avenue Arroyo de los \u00c1ngeles S\/N, 29011 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Marfil Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Materno-Infantil Hospital Regional Universitaria M\u00e1laga, Avenue Arroyo de los \u00c1ngeles S\/N, 29011 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susana","family":"Monis Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Materno-Infantil Hospital Regional Universitaria M\u00e1laga, Avenue Arroyo de los \u00c1ngeles S\/N, 29011 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Suarez Arana","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Materno-Infantil Hospital Regional Universitaria M\u00e1laga, Avenue Arroyo de los \u00c1ngeles S\/N, 29011 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1199-5459","authenticated-orcid":false,"given":"Marta","family":"Blasco Alonso","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Materno-Infantil Hospital Regional Universitaria M\u00e1laga, Avenue Arroyo de los \u00c1ngeles S\/N, 29011 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7286-8656","authenticated-orcid":false,"given":"Jesus","family":"Jimenez Lopez","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Materno-Infantil Hospital Regional Universitaria M\u00e1laga, Avenue Arroyo de los \u00c1ngeles S\/N, 29011 M\u00e1laga, Spain"},{"name":"Department of Surgical Specialties, University of Malaga, 29010 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9148-9881","authenticated-orcid":false,"given":"Isidoro","family":"Narbona Arias","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Materno-Infantil Hospital Regional Universitaria M\u00e1laga, Avenue Arroyo de los \u00c1ngeles S\/N, 29011 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1017\/thg.2016.18","article-title":"Twin Anemia Polycythemia Sequence: Current Views on Pathogenesis, Diagnostic Criteria, Perinatal Management, and Outcome","volume":"19","author":"Tollenaar","year":"2016","journal-title":"Twin Res. Hum. Genet."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1002\/uog.23585","article-title":"Perinatal outcome of pregnancy complicated by twin anemia\u2013polycythemia sequence: Systematic review and meta-analysis","volume":"58","author":"Giorgione","year":"2021","journal-title":"Ultrasound Obs. Gynecol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1159\/000486198","article-title":"In utero Partial Exchange Transfusion Combined with in utero Blood Transfusion for Prenatal Management of Twin Anemia-Polycythemia Sequence","volume":"45","author":"Bahtiyar","year":"2019","journal-title":"Fetal Diagn. Ther."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1002\/uog.15821","article-title":"ISUOG Practice Guidelines: Role of ultrasound in twin pregnancy","volume":"47","author":"Khalil","year":"2016","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.bpobgyn.2022.03.012","article-title":"Pathophysiology, diagnosis, and management of twin anemia polycythemia sequence in monochorionic multiple gestations","volume":"84","author":"Baschat","year":"2022","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4450","DOI":"10.1111\/jog.15042","article-title":"Spontaneous twin anemia-polycythemia sequence from two donors to one recipient in a monochorionic triamniotic pregnancy: Case report and review of the literature","volume":"47","year":"2021","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_7","first-page":"101865","article-title":"Twin-twin transfusion syndrome and twin anemia-polycythemia sequence","volume":"86","author":"Miller","year":"2024","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Nicholas, L., Fischbein, R., Aultman, J., and Ernst-Milner, S. (2019). Dispelling myths about antenatal TAPS: A call for action for routine MCA-PSV doppler screening in the United States. J. Clin. Med., 8.","DOI":"10.3390\/jcm8070977"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1002\/uog.20096","article-title":"Improved prediction of twin anemia\u2013polycythemia sequence by delta middle cerebral artery peak systolic velocity: New antenatal classification system","volume":"53","author":"Tollenaar","year":"2019","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1002\/uog.22042","article-title":"Treatment and outcome of 370 cases with spontaneous or post-laser twin anemia\u2013polycythemia sequence managed in 17 fetal therapy centers","volume":"56","author":"Tollenaar","year":"2020","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_11","unstructured":"Simpson, L.L. (2022). Twin Anemia-Polycythemia Sequence (TAPS), UpToDate. Available online: https:\/\/medilib.ir\/uptodate\/show\/130852."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/14\/9\/1071\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:43:30Z","timestamp":1760111010000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/14\/9\/1071"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,27]]},"references-count":11,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["life14091071"],"URL":"https:\/\/doi.org\/10.3390\/life14091071","relation":{},"ISSN":["2075-1729"],"issn-type":[{"type":"electronic","value":"2075-1729"}],"subject":[],"published":{"date-parts":[[2024,8,27]]}}}