Neonatal hematological and biochemical complications in TTTS and TAPS

Abstract

Monochorionic twins are at increased risk of complications compared to dichorionic twins due to differences in placentas. Nearly all monochorionic twins have placental anastomoses connecting the blood circulation of both twins, whereas dichorionic twins have always two separate placentas without vascular connections. Vascular anastomoses lead to inter-twin blood transfusion, which is ‘balanced’ in uncomplicated monochorionic twins. In twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS) inter-twin blood transfusion is unbalanced, resulting in high mortality rates if left untreated. However, improved antenatal management has led to an increase in perinatal survival. Attention is now shifting towards postnatal complications in survivors. In this thesis hematological and biochemical complications in twins affected by TTTS or TAPS are evaluated, including albumin levels and short-term postnatal renal function and hemoglobin levels in uncomplicated monochorionic twins and dichorionic twins.