Evidence map›Paper›PMID 40387113›Full record

ArticleUltrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology2025

Single fetal demise in twin anemia-polycythemia sequence: perinatal outcome of surviving cotwin.

M J A van de Sande, E Lopriore, M Lanna, Y Ville, L Lewi, A S Weingertner, G Ryan, L Otaño, P Klaritsch, A M B Blanco and 3 more

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In one paragraph

Article in Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

M J A van de SandeDepartment of Obstetrics, Division of Fetal Therapy, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0002-9477-989X
E LoprioreDepartment of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands.
M LannaFetal Therapy Unit 'U. Nicolini', Children's Hospital 'Vittore Buzzi', University of Milan, Milan, Italy.ORCID 0000-0003-0765-1298
Y VilleDepartment of Obstetrics and Maternal-Fetal Medicine, Necker-Enfants Malades Hospital, AP-HP, Paris, France.ORCID 0000-0002-5675-267X
L LewiDepartment of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.ORCID 0000-0002-9884-5778
A S WeingertnerDepartment of Obstetrics and Gynecology, Strasbourg University Hospital, Strasbourg, France.
G RyanFetal Medicine Unit, Ontario Fetal Centre, Mount Sinai Hospital, University of Toronto, Toronto, Canada.
L OtañoMaternal-Fetal Medicine Section, Obstetrics Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
P KlaritschDivision of Obstetrics and Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria.ORCID 0000-0002-7359-4853
A M B BlancoDepartment of Obstetrics and Gynecology, Hospital Carlos van Buren, Valparaíso, Chile.
E BevilacquaDepartment of Women's and Children's Health, Women's Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.ORCID 0000-0002-9791-9552
F SlaghekkeDepartment of Obstetrics, Division of Fetal Therapy, Leiden University Medical Center, Leiden, The Netherlands.
L S A TollenaarDepartment of Obstetrics, Division of Fetal Therapy, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0002-2078-2295

Funding

TAPS Support Foundation
6 · The paper itself

Abstract

objectiveTo evaluate the perinatal outcome after spontaneous single intrauterine fetal demise (IUFD) in monochorionic twin pregnancies with twin anemia-polycythemia sequence (TAPS).

methodsThis was a retrospective study of all monochorionic twin pregnancies with TAPS that underwent spontaneous single IUFD and were registered in the international TAPS Registry between 2014 and 2023. The primary outcomes were mortality and severe neonatal cerebral injury in the surviving cotwin.

resultsA total of 39 twin pregnancies with TAPS that underwent spontaneous single IUFD were included, of which 77% (30/39) developed TAPS after laser surgery for twin-twin transfusion syndrome and 23% (9/39) developed TAPS spontaneously. Single IUFD occurred mostly in the donor twin (35/39 (90%)). The median gestational age at single IUFD was 23.0 (interquartile range (IQR), 20.7-27.9) weeks. The median gestational age at birth of the surviving cotwin was 34.3 (IQR, 32.2-36.0) weeks. Cotwin death occurred in one (3%) case and was due to extreme prematurity and intrauterine fetal infection. None of the surviving cotwins had severe neonatal cerebral injury, nor did any require rescue intrauterine transfusion.

conclusionsIn twin pregnancy with TAPS, the risk of mortality and severe neonatal cerebral injury in the surviving cotwin after spontaneous single IUFD appears to be low, which is probably owing to reduced perimortem transfusion through minuscule placental anastomoses. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Indexed as

AnemiaDiseases in TwinsFetofetal TransfusionPolycythemiaPregnancy, TwinAdultFemaleFetal DeathGestational AgeHumansInfant, NewbornPregnancyPregnancy OutcomeRegistriesRetrospective StudiesTwins, Monozygoticintrauterine fetal demisemonochorionic twinsneonatal morbidityperimortem transfusionsevere cerebral injury

Identifiers

PMID40387113
PMCPMC12209701

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.