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doi:10.1111/jog.12641

J. Obstet. Gynaecol. Res. 2014

Incidence of spontaneous twin anemia–polycythemia sequence in monochorionic–diamniotic twin pregnancies: Single-center prospective study Tae Yokouchi, Takeshi Murakoshi, Takashi Mishima, Hiroko Yano, Madoka Ohashi, Takashi Suzuki, Takashi Shinno, Mitsuru Matsushita, Satoru Nakayama and Yuichi Torii Division of Obstetrics and Perinatology, Maternal and Perinatal Care Center, Seirei Hamamatsu General Hospital, Shizuoka, Japan

Abstract Aim: The purpose of this study was to prospectively estimate the incidence of spontaneous twin anemia– polycythemia sequence (TAPS) in monochorionic–diamniotic twin pregnancies. Methods: We prospectively examined umbilical cord hemoglobin (Hb) and reticulocyte count of consecutive monochorionic–diamniotic twin pregnancies delivered at Seirei Hamamatsu General Hospital from December 2006 to September 2013. We excluded cases of twin–twin transfusion syndrome, intrauterine fetal demise, and missing data (Hb and reticulocyte count missing from the medical record). TAPS was diagnosed using the postnatal criteria of intertwin Hb difference >8.0 g/dL and reticulocyte count ratio >1.7. Acute feto-fetal hemorrhage was defined as Hb difference >7 g/dL and reticulocyte count ratio 8.0 g/dL and reticulocyte count ratio >1.7.6 TAPS stage was classified according to the postnatal Hb difference: stage 1, >8.0 g/dL; stage 2, >11.0 g/dL; stage 3, >14.0 g/dL; stage 4, >17.0 g/dL; and stage 5, >20.0 g/ dL.6 We defined acute feto-fetal hemorrhage as Hb difference >7 g/dL and reticulocyte count ratio