症例 challenge · Imaging / Fetal medicine / Maternal-fetal medicine · teaching

Twin Anemia-Polycythemia Sequence (TAPS) · case challenge

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← View the full flowchartBased on TAPS Delphi consensus

Case #1Imaging / Fetal medicine / Maternal-fetal medicine

📋 Case data

MCDA + MCA-PSV twin discordance + stageStage 3 + donor cardiac involvement (critical Doppler) / stage 4 donor hydrops / stage 5 demise

Data is taken from this pathway's reviewed node text. Work through the pathway step by step.

Step 1 / 1 · MCDA + MCA-PSV twin discordance + stage

MCDA + MCA-PSV twin discordance + stage?

💡 TAPS = chronic unidirectional transfusion through tiny (<1 mm) AV anastomoses in monochorionic twins → donor anemia, recipient polycythemia, but no amniotic fluid discordance (distinguishing it from TTTS). Spontaneous ~3–5%, post-laser ~2–13%. Diagnosis: donor MCA-PSV >1.5 MoM, recipient <1.0 MoM; newer delta MCA-PSV >0.5 MoM (more sensitive). Screen MCA-PSV in MCDA from ~20 weeks (especially after TTTS laser).

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.