Vol 93, No 9 (2022)
Research paper
Published online: 2021-11-05
Twin anaemia polycythaemia sequence: a complicated target for prenatal diagnosis, a current state of knowledge
Abstract
Objectives: Processing of available information on TAPS with a focus on the evaluation of the most sensitive and most specific prenatal diagnostic test. Material and methods: Retrospective analysis of available publications on TAPS with their meta-analytical processing through available electronic medical databases. Evaluation of the most sensitive and specific prenatal diagnostic test with graphical processing of sensitivity and specificity values depending on the TAPS diagnostic criteria used. Results: In total, we found 165 available articles, the oldest from 2007 and the most recent from 2020. Based on the available articles, we evaluated the determination of MCA-PSV with a sensitivity of 83% and a specificity of up to 100% for the currently generally accepted diagnostic criterion TAPS — Delta MCA-PSV > 0.5MoM as the most sensitive and specific method of prenatal diagnosis. Conclusions: The serial determination of MCA-PSV represents the most sensitive and specific prenatal diagnostic test to date (2020) based on available knowledge. Serial measurement of the MCA-PSV since gestational week 20 every two weeks until delivery represents a potential TAPS screening test for all monochorionic pregnancies. The late, or postnatal diagnosis of TAPS can have serious consequences in the form of intrauterine death of the foetus(es) and increased perinatal mortality and morbidity.
Keywords: TTTS (Twin-twin Transfusion Syndrome)TAPS (Twin Anaemia Polycythaemia Sequence)MCA-PSV (Middle Cerebral Artery Peak Systolic Velocity)sensitivityspecificity
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