Journal of Yeungnam Medical Science

Case report

Twin anemia polycythemia sequence in a dichorionic diamniotic pregnancy: a case report: Soo-Young Lee, Jin Young Bae, Seong Yeon Hong; J Yeungnam Med Sci. 2022;39(2):150-152. Published online July 2, 2021; DOI: https://doi.org/10.12701/yujm.2021.01060

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Complications related to the vascular anastomosis of the placental vessels in monochorionic twins are fatal. The clinical syndromes of feto-fetal transfusion include twin anemia polycythemia sequence (TAPS), twin-twin transfusion syndrome, and twin reversed arterial perfusion sequence. We present an extremely rare case of TAPS in a dichorionic diamniotic pregnancy. A 36-year-old woman, gravida 0, para 0, was referred to our hospital with suspected preterm premature membrane rupture. Although her pelvic examination did not reveal specific findings, the non-stress test result showed minimal variability in the first fetus and late deceleration in the second one. An emergency cesarean section was performed. The placenta was fused, and one portion of the placenta was pale, while the other portion was dark red. The hemoglobin level of the first fetus was 7.8 g/dL and that of the second one was 22.2 g/dL.

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Suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report
Tania Jeyaseelan, Panicos Shangaris, Athina Efthymiou, Linzi Martin, Lisa Story, Surabhi Nanda, Neelam Gupta, Mudher Al-Adnani, Andreas Marnerides, Kypros H. Nicolaides, Srividhya Sankaran
Journal of Medical Case Reports.2023;[Epub] CrossRef

Case Report

A successful management after preterm delivery in a patient with severe sepsis during third-trimester pregnancy: Moni Ra, Myungkyu Kim, Mincheol Kim, Sangwoo Shim, Seong Yeon Hong; Yeungnam Univ J Med. 2018;35(1):84-88. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.84

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Abstract PDF: A 33-year-old woman visited the emergency department presenting with fever and dyspnea. She was pregnant with gestational age of 31 weeks and 6 days. She had dysuria for 7 days, and fever and dyspnea for 1 day. The vital signs were as follows: blood pressure 110/70 mmHg, heart rate 118 beats/minute, respiratory rate 28/minute, body temperature 38.7℃, and oxygen saturation by pulse oximetry 84% during inhalation of 5 liters of oxygen by nasal prongs. Crackles were heard over both lung fields. There were no signs of uterine contractions. Chest X-ray and chest computed tomography scan showed multiple consolidations and air bronchograms in both lungs. According to urinalysis, there was pyuria and microscopic hematuria. She was diagnosed with community-acquired pneumonia and urinary tract infection (UTI) that progressed to severe sepsis and acute respiratory failure. We found extended-spectrum beta-lactamase producing Escherichia coli in the blood culture and methicillin-resistant Staphylococcus aureus in the sputum culture. The patient was transferred to the intensive care unit with administration of antibiotics and supplementation of high-flow oxygen. On hospital day 2, hypoxemia was aggravated. She underwent endotracheal intubation and mechanical ventilation. After 3 hours, fetal distress was suspected. Under 100% fraction of inspired oxygen, her oxygen partial pressure was 87 mmHg in the arterial blood. She developed acute kidney injury and thrombocytopenia. We diagnosed her with multi-organ failure due to severe sepsis. After an emergent cesarean section, pneumonia, UTI, and other organ failures gradually recovered. The patient and baby were discharged soon thereafter.

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