Leiden University Scholarly Publications

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Verbeek, L.I. (2017)

Neonatal hematological and biochemical complications in TTTS and TAPS

Doctoral Thesis
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...Show more

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.

 

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Monochorionic twins
Twin-twin transfusion syndrome
Twin anemia
Polycythemia sequence
Neonatal outcome
All authors
Verbeek, L.I.
Supervisor
Lopriore, E.; Oepkes, D.
Committee
Lankester, A.; Fijnvandraat, C.M.; Khalil, A.
Qualification
Doctor (dr.)
Awarding Institution
Medicine, Leiden University
Date
2017-06-13
ISBN (print)
9789090303703

Funding

Sponsorship
Afdeling kindergeneeskunde LUMC; Afdeling verloskunde LUMC; BMA B.V. (Mosos), Chiesi pharmaceuticals B.V., KARL STORZ Endoscopie Nederland B.V.; Toshiba Medical Systems Nederland; Vaco2Med en Vygon Nederland B.V