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Updated: Mar 21, 2026
Accurate and Simple Evaluation of Vascular Anastomoses in Monochorionic Placenta using Colored Dye
Published on: September 5, 2011
Rheology of Twin Anemia-Polycythemia Sequence: Insights from Hemoglobin Electrophoresis - A Case Report
Shane Khan1, Todd Ogilby2, Hakan Buyukdere3
1Division of Maternal-Fetal-Medicine, Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, ON, Canada.
Introduction:
Twin anemia-polycythemia sequence (TAPS) is a recognized complication of monochorionic (MC) twins due to abnormal placental vasculature. Determining the rheology involved within the abnormal placental vasculature may help in identifying the optimum treatment option.
Case Presentation:
We describe a case of TAPS which was treated via intrauterine transfusions (IUTs) with partial exchange transfusions in which additional hemoglobin electrophoresis (HbEp) testing was performed on cordocentesis samples taken before and after IUTs and partial exchange transfusions for the donor and recipient twin, respectively. The aim was to assess the flow dynamics from the donor to recipient twin. No differences in hemoglobin A (HbA) were found in the polycythemic twin after 30 min of IUT of the anemic co-twin but within 13 days of first transfusion, greater than a 3-fold rise in HbA was apparent. Within 5 days of second treatment a further 9% rise in HbA was encountered.
Conclusion:
The use of HbEp testing in this case provided preliminary insights into the fluid dynamics involved in TAPS; however, further studies are required to achieve better understanding.
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