Khalil et al reported criteria for twin anemia-polycythemia sequence (TAPS).The authors are from multiple institutions in Europe and the United States.
Patient selection: twin gestation
(1) initially every 2 weeks
(2) if TAPS identified, then every week
Antenatal measurement: middle cerebral artery peak systolic velocity (MCA PSV), as multiple of mean (MoM)
Criteria 1 (antenatal):
MCA PSV MoM
>= 1.5 * MoM
<= 0.8 * MoM
Criteria 2 (antenatal):
MCA PCV discordance [(anemic MoM) - (polycythemic MoM)] >= 1.0
Criteria 3 (postnatal):
Hemoglobin difference between the neonates >= 8.0 g/dL
Criteria 4 (postnatal):
ratio of reticulocyte count in anemic topolycythemic neonates >= 1.7
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