Let’s talk about the long term effects of TAPS.

If we had to talk about the most frequently asked questions we get about TAPS, this would have to be one of the most common.

What Are The Long Term Effects of TAPS?

Itโ€™s a complex question because weโ€™re only beginning to understand TAPS, and the research on the long-term effects is new. There are also different forms of TAPS, and itโ€™s important to know which type you had, as the long-term effects are different.

From our recent webinar on the long term effects of TAPS.

Post-Laser TAPS.

Post laser TAPS occurs in 16% of cases after selective laser surgery for TAPS and around 3% of cases after Solomon laser surgery.

What do we know about the long-term effects of Post-laser TAPS?

We know that there are a lot of similarities between the long-term effects of post-laser TAPS, and TTTS.

ะšะฐะบ ะฝะฐั‡ะฐั‚ัŒ ะธะณั€ะฐั‚ัŒ ะฒ Riobet ะบะฐะทะธะฝะพ ะดะปั ั€ะพััะธัะฝ: ะŸะพะดั€ะพะฑะฝะพะต ั€ัƒะบะพะฒะพะดัั‚ะฒะพ

ะ’ั‹ ะบะพะณะดะฐ-ะฝะธะฑัƒะดัŒ ะทะฐะดัƒะผั‹ะฒะฐะปะธััŒ ะพ ั‚ะพะผ, ะบะฐะบ ะฝะฐั‡ะฐั‚ัŒ ะธะณั€ะฐั‚ัŒ ะฒ ะพะฝะปะฐะนะฝ-ะบะฐะทะธะฝะพ ะธ ะธัะฟั‹ั‚ะฐั‚ัŒ ะฐะทะฐั€ั‚ ะธะณั€ั‹ ะฟั€ัะผะพ ะธะท ัƒัŽั‚ะฝะพะณะพ ัƒะณะพะปะบะฐ ัะฒะพะตะณะพ ะดะพะผะฐ? ะ•ัะปะธ ะฒั‹ ั€ะพััะธัะฝะธะฝ, ั‚ะพ Riobet ะบะฐะทะธะฝะพ ะผะพะถะตั‚ ัั‚ะฐั‚ัŒ ะธะดะตะฐะปัŒะฝั‹ะผ ะผะตัั‚ะพะผ ะดะปั ะฒะฐั. ะ’ ัั‚ะพะน ัั‚ะฐั‚ัŒะต ะผั‹ ะฟั€ะตะดัั‚ะฐะฒะธะผ ะฒะฐะผ ะฟะพะดั€ะพะฑะฝะพะต ั€ัƒะบะพะฒะพะดัั‚ะฒะพ ะพ ั‚ะพะผ, ะบะฐะบ ะฝะฐั‡ะฐั‚ัŒ ะธะณั€ะฐั‚ัŒ ะฒ Riobet ะบะฐะทะธะฝะพ, ั‡ั‚ะพะฑั‹ ะฒั‹ ะผะพะณะปะธ ะฝะฐัะปะฐะดะธั‚ัŒัั ัƒะฒะปะตะบะฐั‚ะตะปัŒะฝั‹ะผะธ ะธะณั€ะฐะผะธ ะธ ะฒะพะทะผะพะถะฝะพัั‚ัŒัŽ ะฒั‹ะธะณั€ะฐั‚ัŒ ะบั€ัƒะฟะฝั‹ะต ััƒะผะผั‹ ะดะตะฝะตะณ. ะะตะทะฐะฒะธัะธะผะพ ะพั‚ ั‚ะพะณะพ, ัะฒะปัะตั‚ะตััŒ ะปะธ ะฒั‹ ะฝะพะฒะธั‡ะบะพะผ ะฒ ะผะธั€ะต ะพะฝะปะฐะนะฝ-ะบะฐะทะธะฝะพ ะธะปะธ ัƒะถะต ะธะผะตะตั‚ะต ะพะฟั‹ั‚, ะทะดะตััŒ ะฒั‹ ะฝะฐะนะดะตั‚ะต ะฟะพะปะตะทะฝั‹ะต ัะพะฒะตั‚ั‹ ะธ ะธะฝั„ะพั€ะผะฐั†ะธัŽ, ะบะพั‚ะพั€ั‹ะต ะฟะพะผะพะณัƒั‚ ะฒะฐะผ ัั‚ะฐั‚ัŒ ัƒัะฟะตัˆะฝั‹ะผ ะธะณั€ะพะบะพะผ.

ะฃะทะฝะฐะนั‚ะต, ะบะฐะบ ะฒั‹ะฑั€ะฐั‚ัŒ ะฟะพะดั…ะพะดัั‰ะตะต ะบะฐะทะธะฝะพ, ะบะฐะบ ะทะฐั€ะตะณะธัั‚ั€ะธั€ะพะฒะฐั‚ัŒัั, ะบะฐะบ ะฟะพะฟะพะปะฝะธั‚ัŒ ัะฒะพะน ัั‡ะตั‚ ะธ ะบะฐะบ ะฟะพะปัƒั‡ะธั‚ัŒ ะฑะพะฝัƒัั‹, ะบะพั‚ะพั€ั‹ะต ะฟะพะผะพะณัƒั‚ ะฒะฐะผ ัƒะฒะตะปะธั‡ะธั‚ัŒ ัะฒะพะธ ัˆะฐะฝัั‹ ะฝะฐ ะฒั‹ะธะณั€ั‹ัˆ. ะœั‹ ั‚ะฐะบะถะต ั€ะฐััะบะฐะถะตะผ ะฒะฐะผ ะพ ั€ะฐะทะปะธั‡ะฝั‹ั… ะธะณั€ะฐั…, ะดะพัั‚ัƒะฟะฝั‹ั… ะฒ Riobet ะบะฐะทะธะฝะพ, ะธ ะฟะพะดะตะปะธะผัั ัะตะบั€ะตั‚ะฐะผะธ, ะบะพั‚ะพั€ั‹ะต ะฟะพะผะพะณัƒั‚ ะฒะฐะผ ั€ะฐะทะฒะธั‚ัŒ ัะฒะพะธ ะฝะฐะฒั‹ะบะธ ะธ ัั‚ั€ะฐั‚ะตะณะธะธ. ะ“ะพั‚ะพะฒั‹ ะปะธ ะฒั‹ ะพะบัƒะฝัƒั‚ัŒัั ะฒ ะทะฐั…ะฒะฐั‚ั‹ะฒะฐัŽั‰ะธะน ะผะธั€ ะพะฝะปะฐะนะฝ-ะบะฐะทะธะฝะพ ะธ ะธัะฟั‹ั‚ะฐั‚ัŒ ัะฒะพัŽ ัƒะดะฐั‡ัƒ? ะ”ะฐะฒะฐะนั‚ะต ะฝะฐั‡ะฝะตะผ ัั‚ะพั‚ ัƒะฒะปะตะบะฐั‚ะตะปัŒะฝั‹ะน ะฟัƒั‚ัŒ ะฒะผะตัั‚ะต ะธ ัƒะทะฝะฐะตะผ ะฒัะต, ั‡ั‚ะพ ะฒะฐะผ ะฝัƒะถะฝะพ ะทะฝะฐั‚ัŒ ะพ Riobet ะบะฐะทะธะฝะพ ะดะปั ั€ะพััะธัะฝ!

ะ’ั‹ะฑะพั€ ะฝะฐะดะตะถะฝะพะณะพ ะบะฐะทะธะฝะพ: ะบั€ะธั‚ะตั€ะธะธ ะธ ั€ะตะบะพะผะตะฝะดะฐั†ะธะธ

ะšะฐะทะธะฝะพ Riobet – ัั‚ะพ ะฟะพะฟัƒะปัั€ะฝะพะต ะพะฝะปะฐะนะฝ-ะบะฐะทะธะฝะพ, ะฟั€ะตะดะปะฐะณะฐัŽั‰ะตะต ั€ะฐะทะฝะพะพะฑั€ะฐะทะฝั‹ะต ะฐะทะฐั€ั‚ะฝั‹ะต ะธะณั€ั‹ ะดะปั ั€ะพััะธะนัะบะธั… ะธะณั€ะพะบะพะฒ. ะงั‚ะพะฑั‹ ะฝะฐั‡ะฐั‚ัŒ ะธะณั€ะฐั‚ัŒ ะฒ Riobet ะบะฐะทะธะฝะพ, ะฒะฐะผ ะฝะตะพะฑั…ะพะดะธะผะพ ะฒั‹ะฟะพะปะฝะธั‚ัŒ ะฝะตัะบะพะปัŒะบะพ ะฟั€ะพัั‚ั‹ั… ัˆะฐะณะพะฒ.

1. ะ—ะฐั€ะตะณะธัั‚ั€ะธั€ัƒะนั‚ะตััŒ ะฝะฐ ะพั„ะธั†ะธะฐะปัŒะฝะพะผ ัะฐะนั‚ะต Riobet ะบะฐะทะธะฝะพ. ะ”ะปั ัั‚ะพะณะพ ะฟะตั€ะตะนะดะธั‚ะต ะฟะพ ััั‹ะปะบะต (ะฒัั‚ะฐะฒะธั‚ัŒ ััั‹ะปะบัƒ) ะธ ะฝะฐะถะผะธั‚ะต ะฝะฐ ะบะฝะพะฟะบัƒ “ะ ะตะณะธัั‚ั€ะฐั†ะธั”. ะ—ะฐะฟะพะปะฝะธั‚ะต ะฒัะต ะฝะตะพะฑั…ะพะดะธะผั‹ะต ะดะฐะฝะฝั‹ะต, ะฒะบะปัŽั‡ะฐั ะฒะฐัˆะต ะธะผั, ัะปะตะบั‚ั€ะพะฝะฝัƒัŽ ะฟะพั‡ั‚ัƒ ะธ ะฟะฐั€ะพะปัŒ. ะŸะพัะปะต ะทะฐะฒะตั€ัˆะตะฝะธั ั€ะตะณะธัั‚ั€ะฐั†ะธะธ ะฒะฐะผ ะฑัƒะดะตั‚ ะฟั€ะตะดะพัั‚ะฐะฒะปะตะฝ ัƒะฝะธะบะฐะปัŒะฝั‹ะน ะฐะบะบะฐัƒะฝั‚, ั ะบะพั‚ะพั€ั‹ะผ ะฒั‹ ัะผะพะถะตั‚ะต ะฒะพะนั‚ะธ ะฝะฐ ัะฐะนั‚ ะบะฐะทะธะฝะพ.

2. ะŸะพะฟะพะปะฝะธั‚ะต ัะฒะพะน ะธะณั€ะพะฒะพะน ัั‡ะตั‚. Riobet ะบะฐะทะธะฝะพ ะฟั€ะตะดะปะฐะณะฐะตั‚ ั€ะฐะทะปะธั‡ะฝั‹ะต ัะฟะพัะพะฑั‹ ะฟะพะฟะพะปะฝะตะฝะธั, ะฒะบะปัŽั‡ะฐั ะฑะฐะฝะบะพะฒัะบะธะต ะบะฐั€ั‚ั‹, ัะปะตะบั‚ั€ะพะฝะฝั‹ะต ะบะพัˆะตะปัŒะบะธ ะธ ะบั€ะธะฟั‚ะพะฒะฐะปัŽั‚ั‹. ะ’ั‹ะฑะตั€ะธั‚ะต ัƒะดะพะฑะฝั‹ะน ะดะปั ะฒะฐั ัะฟะพัะพะฑ ะธ ัะปะตะดัƒะนั‚ะต ะธะฝัั‚ั€ัƒะบั†ะธัะผ ะฝะฐ ัะฐะนั‚ะต. ะžะฑั€ะฐั‚ะธั‚ะต ะฒะฝะธะผะฐะฝะธะต, ั‡ั‚ะพ ะฝะตะบะพั‚ะพั€ั‹ะต ัะฟะพัะพะฑั‹ ะฟะพะฟะพะปะฝะตะฝะธั ะผะพะณัƒั‚ ะฑั‹ั‚ัŒ ะดะพัั‚ัƒะฟะฝั‹ ั‚ะพะปัŒะบะพ ะดะปั ั€ะพััะธะนัะบะธั… ะธะณั€ะพะบะพะฒ.

3. ะ’ั‹ะฑะตั€ะธั‚ะต ะธะณั€ัƒ ะธ ะฝะฐั‡ะฝะธั‚ะต ะธะณั€ะฐั‚ัŒ. Riobet ะบะฐะทะธะฝะพ ะฟั€ะตะดะปะฐะณะฐะตั‚ ัˆะธั€ะพะบะธะน ะฒั‹ะฑะพั€ ะฐะทะฐั€ั‚ะฝั‹ั… ะธะณั€, ะฒะบะปัŽั‡ะฐั ัะปะพั‚ั‹, ั€ัƒะปะตั‚ะบัƒ, ะฟะพะบะตั€ ะธ ะผะฝะพะณะพะต ะดั€ัƒะณะพะต. ะŸะตั€ะตะนะดะธั‚ะต ะฒ ัะพะพั‚ะฒะตั‚ัั‚ะฒัƒัŽั‰ะธะน ั€ะฐะทะดะตะป ะฝะฐ ัะฐะนั‚ะต ะธ ะฒั‹ะฑะตั€ะธั‚ะต ะธะณั€ัƒ, ะบะพั‚ะพั€ะฐั ะฒะฐะผ ะฝั€ะฐะฒะธั‚ัั. ะะฐะถะผะธั‚ะต ะฝะฐ ะฝะตะต ะธ ะฝะฐั‡ะฝะธั‚ะต ะธะณั€ัƒ. ะะต ะทะฐะฑัƒะดัŒั‚ะต ัƒัั‚ะฐะฝะพะฒะธั‚ัŒ ัั‚ะฐะฒะบัƒ ะธ ะพะทะฝะฐะบะพะผะธั‚ัŒัั ั ะฟั€ะฐะฒะธะปะฐะผะธ ะธะณั€ั‹.

ะ ะตะณะธัั‚ั€ะฐั†ะธั ะธ ัะพะทะดะฐะฝะธะต ะฐะบะบะฐัƒะฝั‚ะฐ ะฒ Riobet ะบะฐะทะธะฝะพ

ะ•ัะปะธ ะฒั‹ ั€ะพััะธะนัะบะธะน ะธะณั€ะพะบ ะธ ั…ะพั‚ะธั‚ะต ะฝะฐั‡ะฐั‚ัŒ ะธะณั€ะฐั‚ัŒ ะฒ ะพะฝะปะฐะนะฝ-ะบะฐะทะธะฝะพ Riobet, ั‚ะพ ะดะปั ะฒะฐั ะตัั‚ัŒ ะฟะพะดั€ะพะฑะฝะพะต ั€ัƒะบะพะฒะพะดัั‚ะฒะพ. ะ’ ะฟะตั€ะฒัƒัŽ ะพั‡ะตั€ะตะดัŒ, ะฒะฐะผ ะฝะตะพะฑั…ะพะดะธะผะพ ะฟะตั€ะตะนั‚ะธ ะฝะฐ ะพั„ะธั†ะธะฐะปัŒะฝั‹ะน ัะฐะนั‚ ะบะฐะทะธะฝะพ, ะบะพั‚ะพั€ั‹ะน ะผะพะถะฝะพ ะฝะฐะนั‚ะธ ะฟะพ ััั‹ะปะบะต https://riobet247.com/. ะŸะพัะปะต ั‚ะพะณะพ, ะบะฐะบ ะฒั‹ ะพั‚ะบั€ะพะตั‚ะต ัะฐะนั‚, ะฒั‹ ัƒะฒะธะดะธั‚ะต ัƒะดะพะฑะฝั‹ะน ะธ ะธะฝั‚ัƒะธั‚ะธะฒะฝะพ ะฟะพะฝัั‚ะฝั‹ะน ะธะฝั‚ะตั€ั„ะตะนั.

ะ”ะปั ั€ะตะณะธัั‚ั€ะฐั†ะธะธ ะฝะฐ ัะฐะนั‚ะต Riobet ะบะฐะทะธะฝะพ ะฒะฐะผ ะฟะพั‚ั€ะตะฑัƒะตั‚ัั ะทะฐะฟะพะปะฝะธั‚ัŒ ะฝะตะฑะพะปัŒัˆัƒัŽ ั„ะพั€ะผัƒ, ัƒะบะฐะทะฐะฒ ัะฒะพะธ ะปะธั‡ะฝั‹ะต ะดะฐะฝะฝั‹ะต. ะŸะพัะปะต ัƒัะฟะตัˆะฝะพะน ั€ะตะณะธัั‚ั€ะฐั†ะธะธ ะฒะฐะผ ัั‚ะฐะฝะตั‚ ะดะพัั‚ัƒะฟะตะฝ ะฑะพะปัŒัˆะพะน ะฒั‹ะฑะพั€ ะฐะทะฐั€ั‚ะฝั‹ั… ะธะณั€, ะฒะบะปัŽั‡ะฐั ัะปะพั‚ั‹, ั€ัƒะปะตั‚ะบัƒ, ะฑะปัะบะดะถะตะบ ะธ ะดั€ัƒะณะธะต. Riobet ะฟั€ะตะดะปะฐะณะฐะตั‚ ั€ะฐะทะฝะพะพะฑั€ะฐะทะฝั‹ะต ะฑะพะฝัƒัั‹ ะธ ะฐะบั†ะธะธ, ะบะพั‚ะพั€ั‹ะต ะฟะพะผะพะณัƒั‚ ะฒะฐะผ ะฟะพะปัƒั‡ะธั‚ัŒ ะดะพะฟะพะปะฝะธั‚ะตะปัŒะฝั‹ะต ะฒั‹ะณะพะดั‹ ะฟั€ะธ ะธะณั€ะต. ะŸะพะผะธะผะพ ัั‚ะพะณะพ, ะบะฐะทะธะฝะพ ะฟั€ะตะดะปะฐะณะฐะตั‚ ัƒะดะพะฑะฝั‹ะต ัะฟะพัะพะฑั‹ ะฟะพะฟะพะปะฝะตะฝะธั ะธ ะฒั‹ะฒะพะดะฐ ัั€ะตะดัั‚ะฒ, ั‡ั‚ะพะฑั‹ ะฒั‹ ะผะพะณะปะธ ะฝะฐัะปะฐะถะดะฐั‚ัŒัั ะธะณั€ะพะน ะฑะตะท ะฟั€ะพะฑะปะตะผ.

ะžัะฝะพะฒะฝั‹ะต ะธะณั€ะพะฒั‹ะต ะบะฐั‚ะตะณะพั€ะธะธ ะธ ะฟะพะฟัƒะปัั€ะฝั‹ะต ะธะณั€ั‹ ะฒ Riobet ะบะฐะทะธะฝะพ

ะ•ัะปะธ ะฒั‹ ั…ะพั‚ะธั‚ะต ะฝะฐั‡ะฐั‚ัŒ ะธะณั€ะฐั‚ัŒ ะฒ ะพะฝะปะฐะนะฝ-ะบะฐะทะธะฝะพ Riobet, ั‚ะพ ะฒะฐะผ ะฟะพั‚ั€ะตะฑัƒะตั‚ัั ัะปะตะดะพะฒะฐั‚ัŒ ะฝะตัะบะพะปัŒะบะธะผ ะฟั€ะพัั‚ั‹ะผ ัˆะฐะณะฐะผ. ะ’ะพ-ะฟะตั€ะฒั‹ั…, ะฒะฐะผ ะฝัƒะถะฝะพ ะทะฐั€ะตะณะธัั‚ั€ะธั€ะพะฒะฐั‚ัŒัั ะฝะฐ ะพั„ะธั†ะธะฐะปัŒะฝะพะผ ัะฐะนั‚ะต Riobet. ะ”ะปั ัั‚ะพะณะพ ะฝะฐะถะผะธั‚ะต ะฝะฐ ะบะฝะพะฟะบัƒ “ะ ะตะณะธัั‚ั€ะฐั†ะธั” ะฒ ะฒะตั€ั…ะฝะตะผ ะฟั€ะฐะฒะพะผ ัƒะณะปัƒ ะณะปะฐะฒะฝะพะน ัั‚ั€ะฐะฝะธั†ั‹. ะ—ะฐะฟะพะปะฝะธั‚ะต ะฒัะต ะฝะตะพะฑั…ะพะดะธะผั‹ะต ะฟะพะปั, ะฒะบะปัŽั‡ะฐั ะปะพะณะธะฝ, ะฟะฐั€ะพะปัŒ ะธ ะฐะดั€ะตั ัะปะตะบั‚ั€ะพะฝะฝะพะน ะฟะพั‡ั‚ั‹. ะŸะพัะปะต ัั‚ะพะณะพ ะฒะฐะผ ะฑัƒะดะตั‚ ะฟั€ะตะดะปะพะถะตะฝะพ ะฟะพะดั‚ะฒะตั€ะดะธั‚ัŒ ัะฒะพัŽ ั€ะตะณะธัั‚ั€ะฐั†ะธัŽ ะฟะพ ัะปะตะบั‚ั€ะพะฝะฝะพะน ะฟะพั‡ั‚ะต.

ะŸะพัะปะต ัƒัะฟะตัˆะฝะพะน ั€ะตะณะธัั‚ั€ะฐั†ะธะธ ะฒะฐะผ ะฝัƒะถะฝะพ ะฟะพะฟะพะปะฝะธั‚ัŒ ัะฒะพะน ะธะณั€ะพะฒะพะน ัั‡ะตั‚. Riobet ะฟั€ะตะดะปะฐะณะฐะตั‚ ั€ะฐะทะปะธั‡ะฝั‹ะต ัะฟะพัะพะฑั‹ ะฟะพะฟะพะปะฝะตะฝะธั, ะฒะบะปัŽั‡ะฐั ะฑะฐะฝะบะพะฒัะบะธะต ะบะฐั€ั‚ั‹, ัะปะตะบั‚ั€ะพะฝะฝั‹ะต ะบะพัˆะตะปัŒะบะธ ะธ ะบั€ะธะฟั‚ะพะฒะฐะปัŽั‚ั‹. ะ’ั‹ะฑะตั€ะธั‚ะต ัƒะดะพะฑะฝั‹ะน ะดะปั ะฒะฐั ัะฟะพัะพะฑ ะธ ัะปะตะดัƒะนั‚ะต ะธะฝัั‚ั€ัƒะบั†ะธัะผ ะฝะฐ ัะฐะนั‚ะต ะดะปั ะทะฐะฒะตั€ัˆะตะฝะธั ะฟะปะฐั‚ะตะถะฐ. ะžะฑั€ะฐั‚ะธั‚ะต ะฒะฝะธะผะฐะฝะธะต, ั‡ั‚ะพ ะฝะตะบะพั‚ะพั€ั‹ะต ัะฟะพัะพะฑั‹ ะผะพะณัƒั‚ ะฒะทะธะผะฐั‚ัŒ ะบะพะผะธััะธัŽ.

ะŸะพัะปะต ะฟะพะฟะพะปะฝะตะฝะธั ัั‡ะตั‚ะฐ ะฒั‹ ะณะพั‚ะพะฒั‹ ะฝะฐั‡ะฐั‚ัŒ ะธะณั€ะฐั‚ัŒ. Riobet ะฟั€ะตะดะปะฐะณะฐะตั‚ ัˆะธั€ะพะบะธะน ะฒั‹ะฑะพั€ ะธะณั€, ะฒะบะปัŽั‡ะฐั ัะปะพั‚ั‹, ั€ัƒะปะตั‚ะบัƒ, ะฟะพะบะตั€ ะธ ะผะฝะพะณะพะต ะดั€ัƒะณะพะต. ะงั‚ะพะฑั‹ ะฝะฐะนั‚ะธ ะธะฝั‚ะตั€ะตััƒัŽั‰ัƒัŽ ะฒะฐั ะธะณั€ัƒ, ะฒะพัะฟะพะปัŒะทัƒะนั‚ะตััŒ ัƒะดะพะฑะฝั‹ะผ ั„ะธะปัŒั‚ั€ะพะผ ะฟะพ ะบะฐั‚ะตะณะพั€ะธัะผ ะธะปะธ ะฒะพัะฟะพะปัŒะทัƒะนั‚ะตััŒ ะฟะพะธัะบะพะผ ะฟะพ ะฝะฐะทะฒะฐะฝะธัŽ. ะšะปะธะบะฝะธั‚ะต ะฝะฐ ะฒั‹ะฑั€ะฐะฝะฝัƒัŽ ะธะณั€ัƒ, ั‡ั‚ะพะฑั‹ ะพั‚ะบั€ั‹ั‚ัŒ ะตะต ะฒ ะฑั€ะฐัƒะทะตั€ะต ะธ ะฝะฐั‡ะฐั‚ัŒ ะธะณั€ะฐั‚ัŒ. ะฃะดะฐั‡ะธ!

ะ‘ะพะฝัƒัั‹ ะธ ะฐะบั†ะธะธ: ะบะฐะบ ะฟะพะปัƒั‡ะธั‚ัŒ ะดะพะฟะพะปะฝะธั‚ะตะปัŒะฝั‹ะต ะฒั‹ะณะพะดั‹ ะฟั€ะธ ะธะณั€ะต

ะ•ัะปะธ ะฒั‹ ั€ะพััะธะนัะบะธะน ะธะณั€ะพะบ ะธ ั…ะพั‚ะธั‚ะต ะฝะฐั‡ะฐั‚ัŒ ะธะณั€ะฐั‚ัŒ ะฒ ะพะฝะปะฐะนะฝ-ะบะฐะทะธะฝะพ Riobet, ะฒะฐะผ ะฟะพั‚ั€ะตะฑัƒะตั‚ัั ัะปะตะดะพะฒะฐั‚ัŒ ะฝะตัะบะพะปัŒะบะธะผ ะฟั€ะพัั‚ั‹ะผ ัˆะฐะณะฐะผ. ะ’ะพ-ะฟะตั€ะฒั‹ั…, ะฒะฐะผ ะฝัƒะถะฝะพ ะทะฐั€ะตะณะธัั‚ั€ะธั€ะพะฒะฐั‚ัŒัั ะฝะฐ ะพั„ะธั†ะธะฐะปัŒะฝะพะผ ัะฐะนั‚ะต Riobet. ะ”ะปั ัั‚ะพะณะพ ะฟะตั€ะตะนะดะธั‚ะต ะฟะพ ััั‹ะปะบะต, ะบะพั‚ะพั€ัƒัŽ ะฒั‹ ะผะพะถะตั‚ะต ะฝะฐะนั‚ะธ ะฝะฐ ะธั… ะพั„ะธั†ะธะฐะปัŒะฝะพะผ ัะฐะนั‚ะต. ะะฐะถะผะธั‚ะต ะฝะฐ ะบะฝะพะฟะบัƒ “ะ ะตะณะธัั‚ั€ะฐั†ะธั” ะธ ะทะฐะฟะพะปะฝะธั‚ะต ะฒัะต ะฝะตะพะฑั…ะพะดะธะผั‹ะต ะดะฐะฝะฝั‹ะต, ั‚ะฐะบะธะต ะบะฐะบ ะธะผั, ัะปะตะบั‚ั€ะพะฝะฝะฐั ะฟะพั‡ั‚ะฐ ะธ ะฟะฐั€ะพะปัŒ.

ะŸะพัะปะต ั€ะตะณะธัั‚ั€ะฐั†ะธะธ ะฒะฐะผ ะฟะพั‚ั€ะตะฑัƒะตั‚ัั ะฟะพะฟะพะปะฝะธั‚ัŒ ัะฒะพะน ะธะณั€ะพะฒะพะน ัั‡ะตั‚. Riobet ะฟั€ะตะดะปะฐะณะฐะตั‚ ั€ะฐะทะปะธั‡ะฝั‹ะต ัะฟะพัะพะฑั‹ ะฟะพะฟะพะปะฝะตะฝะธั, ะฒะบะปัŽั‡ะฐั ะฑะฐะฝะบะพะฒัะบะธะต ะบะฐั€ั‚ั‹, ัะปะตะบั‚ั€ะพะฝะฝั‹ะต ะบะพัˆะตะปัŒะบะธ ะธ ะบั€ะธะฟั‚ะพะฒะฐะปัŽั‚ั‹. ะ’ั‹ะฑะตั€ะธั‚ะต ะฝะฐะธะฑะพะปะตะต ัƒะดะพะฑะฝั‹ะน ะดะปั ะฒะฐั ัะฟะพัะพะฑ ะธ ัะปะตะดัƒะนั‚ะต ะธะฝัั‚ั€ัƒะบั†ะธัะผ ะฝะฐ ัะฐะนั‚ะต, ั‡ั‚ะพะฑั‹ ะฟะพะฟะพะปะฝะธั‚ัŒ ัะฒะพะน ัั‡ะตั‚.

ะŸะพัะปะต ัƒัะฟะตัˆะฝะพะณะพ ะฟะพะฟะพะปะฝะตะฝะธั ัั‡ะตั‚ะฐ ะฒั‹ ะผะพะถะตั‚ะต ะฝะฐั‡ะฐั‚ัŒ ะธะณั€ะฐั‚ัŒ ะฒ ะบะฐะทะธะฝะพ Riobet. ะžะฝะธ ะฟั€ะตะดะปะฐะณะฐัŽั‚ ัˆะธั€ะพะบะธะน ะฒั‹ะฑะพั€ ะธะณั€, ะฒะบะปัŽั‡ะฐั ัะปะพั‚ั‹, ั€ัƒะปะตั‚ะบัƒ, ะฑะปัะบะดะถะตะบ ะธ ะดั€ัƒะณะธะต ะฐะทะฐั€ั‚ะฝั‹ะต ะธะณั€ั‹. ะŸั€ะพัั‚ะพ ะฒั‹ะฑะตั€ะธั‚ะต ะธะณั€ัƒ, ะบะพั‚ะพั€ะฐั ะฒะฐะผ ะฝั€ะฐะฒะธั‚ัั, ะธ ะฝะฐั‡ะฝะธั‚ะต ะธะณั€ะฐั‚ัŒ. ะฃะฑะตะดะธั‚ะตััŒ, ั‡ั‚ะพ ะฒั‹ ะธะณั€ะฐะตั‚ะต ะพั‚ะฒะตั‚ัั‚ะฒะตะฝะฝะพ ะธ ัƒัั‚ะฐะฝะฐะฒะปะธะฒะฐะตั‚ะต ะปะธะผะธั‚ั‹ ะฝะฐ ัะฒะพะธ ัั‚ะฐะฒะบะธ, ั‡ั‚ะพะฑั‹ ะฝะต ะฟั€ะตะฒั‹ัˆะฐั‚ัŒ ัะฒะพะธ ั„ะธะฝะฐะฝัะพะฒั‹ะต ะฒะพะทะผะพะถะฝะพัั‚ะธ.

ะกะฟะพัะพะฑั‹ ะฟะพะฟะพะปะฝะตะฝะธั ะธ ะฒั‹ะฒะพะดะฐ ัั€ะตะดัั‚ะฒ: ัƒะดะพะฑะฝั‹ะต ะธ ะฑะตะทะพะฟะฐัะฝั‹ะต ะผะตั‚ะพะดั‹ ั‚ั€ะฐะฝะทะฐะบั†ะธะน

ะ”ะปั ั€ะพััะธะนัะบะธั… ะธะณั€ะพะบะพะฒ, ะบะพั‚ะพั€ั‹ะต ั…ะพั‚ัั‚ ะฝะฐั‡ะฐั‚ัŒ ะธะณั€ะฐั‚ัŒ ะฒ ะพะฝะปะฐะนะฝ-ะบะฐะทะธะฝะพ Riobet, ะผั‹ ะฟั€ะตะดะปะฐะณะฐะตะผ ะฟะพะดั€ะพะฑะฝะพะต ั€ัƒะบะพะฒะพะดัั‚ะฒะพ. ะญั‚ะพ ะบะฐะทะธะฝะพ ะฟั€ะตะดะปะฐะณะฐะตั‚ ัˆะธั€ะพะบะธะน ะฒั‹ะฑะพั€ ะธะณั€, ั‰ะตะดั€ั‹ะต ะฑะพะฝัƒัั‹ ะธ ัƒะดะพะฑะฝั‹ะน ะธะฝั‚ะตั€ั„ะตะนั, ั‡ั‚ะพะฑั‹ ะฒั‹ ะผะพะณะปะธ ะฝะฐัะปะฐะถะดะฐั‚ัŒัั ะฐะทะฐั€ั‚ะพะผ ะฟั€ัะผะพ ะธะท ะบะพะผั„ะพั€ั‚ะฐ ัะฒะพะตะณะพ ะดะพะผะฐ. ะ’ะพั‚ ะฝะตัะบะพะปัŒะบะพ ัˆะฐะณะพะฒ, ะบะพั‚ะพั€ั‹ะต ะฟะพะผะพะณัƒั‚ ะฒะฐะผ ะฝะฐั‡ะฐั‚ัŒ ะธะณั€ะฐั‚ัŒ ะฒ Riobet ะบะฐะทะธะฝะพ.

ะŸะตั€ะฒั‹ะผ ัˆะฐะณะพะผ ัะฒะปัะตั‚ัั ั€ะตะณะธัั‚ั€ะฐั†ะธั ะฝะฐ ะพั„ะธั†ะธะฐะปัŒะฝะพะผ ัะฐะนั‚ะต Riobet. ะ”ะปั ัั‚ะพะณะพ ะฟั€ะพัั‚ะพ ะฟะตั€ะตะนะดะธั‚ะต ะฟะพ ััั‹ะปะบะต ะฝะฐ ะธั… ัะฐะนั‚ ะธ ะฝะฐะถะผะธั‚ะต ะบะฝะพะฟะบัƒ “ะ ะตะณะธัั‚ั€ะฐั†ะธั”. ะ—ะฐะฟะพะปะฝะธั‚ะต ะฝะตะพะฑั…ะพะดะธะผั‹ะต ะดะฐะฝะฝั‹ะต, ั‚ะฐะบะธะต ะบะฐะบ ะธะผั, ั„ะฐะผะธะปะธัŽ, ัะปะตะบั‚ั€ะพะฝะฝัƒัŽ ะฟะพั‡ั‚ัƒ ะธ ะฟั€ะธะดัƒะผะฐะนั‚ะต ะฝะฐะดะตะถะฝั‹ะน ะฟะฐั€ะพะปัŒ. ะŸะพัะปะต ั€ะตะณะธัั‚ั€ะฐั†ะธะธ ะฒะฐะผ ะฑัƒะดะตั‚ ะฟั€ะตะดะปะพะถะตะฝะพ ะฟะพะดั‚ะฒะตั€ะดะธั‚ัŒ ัะฒะพะน ะฐะบะบะฐัƒะฝั‚ ั‡ะตั€ะตะท ัะปะตะบั‚ั€ะพะฝะฝัƒัŽ ะฟะพั‡ั‚ัƒ.

ะŸะพัะปะต ัƒัะฟะตัˆะฝะพะน ั€ะตะณะธัั‚ั€ะฐั†ะธะธ ะฒั‹ ะผะพะถะตั‚ะต ะฒะฝะตัั‚ะธ ะดะตะฟะพะทะธั‚ ะฝะฐ ัะฒะพะน ะธะณั€ะพะฒะพะน ัั‡ะตั‚. Riobet ะฟั€ะตะดะปะฐะณะฐะตั‚ ั€ะฐะทะปะธั‡ะฝั‹ะต ัะฟะพัะพะฑั‹ ะฟะพะฟะพะปะฝะตะฝะธั, ะฒะบะปัŽั‡ะฐั ะฑะฐะฝะบะพะฒัะบะธะต ะบะฐั€ั‚ั‹, ัะปะตะบั‚ั€ะพะฝะฝั‹ะต ะบะพัˆะตะปัŒะบะธ ะธ ะบั€ะธะฟั‚ะพะฒะฐะปัŽั‚ั‹. ะ’ั‹ะฑะตั€ะธั‚ะต ะฝะฐะธะฑะพะปะตะต ัƒะดะพะฑะฝั‹ะน ะดะปั ะฒะฐั ัะฟะพัะพะฑ ะธ ัะปะตะดัƒะนั‚ะต ะธะฝัั‚ั€ัƒะบั†ะธัะผ ะฝะฐ ัะฐะนั‚ะต. ะŸะพัะปะต ะฟะพะฟะพะปะฝะตะฝะธั ัั‡ะตั‚ะฐ ะฒั‹ ัะผะพะถะตั‚ะต ะฝะฐั‡ะฐั‚ัŒ ะธะณั€ะฐั‚ัŒ ะฒ ะปัŽะฑะธะผั‹ะต ะบะฐะทะธะฝะพ ะธะณั€ั‹.

ะะต ะทะฐะฑัƒะดัŒั‚ะต ะฒะพัะฟะพะปัŒะทะพะฒะฐั‚ัŒัั ะฑะพะฝัƒัะฐะผะธ, ะบะพั‚ะพั€ั‹ะต ะฟั€ะตะดะปะฐะณะฐะตั‚ Riobet. ะžะฝะธ ะฟั€ะตะดะปะฐะณะฐัŽั‚ ั€ะฐะทะปะธั‡ะฝั‹ะต ะฐะบั†ะธะธ ะธ ะฑะพะฝัƒัั‹ ะดะปั ะฝะพะฒั‹ั… ะธะณั€ะพะบะพะฒ, ั‚ะฐะบะธะต ะบะฐะบ ะฑะตัะฟะปะฐั‚ะฝั‹ะต ะฒั€ะฐั‰ะตะฝะธั ะธ ะฑะพะฝัƒัะฝั‹ะต ะดะตะฝัŒะณะธ ะฝะฐ ะฟะตั€ะฒั‹ะน ะดะตะฟะพะทะธั‚. ะžะทะฝะฐะบะพะผัŒั‚ะตััŒ ั ัƒัะปะพะฒะธัะผะธ ะบะฐะถะดะพะณะพ ะฑะพะฝัƒัะฐ ะธ ัะปะตะดัƒะนั‚ะต ะธะฝัั‚ั€ัƒะบั†ะธัะผ, ั‡ั‚ะพะฑั‹ ะฟะพะปัƒั‡ะธั‚ัŒ ะผะฐะบัะธะผะฐะปัŒะฝัƒัŽ ะฒั‹ะณะพะดัƒ. ะขะตะฟะตั€ัŒ ะฒั‹ ะณะพั‚ะพะฒั‹ ะฝะฐั‡ะฐั‚ัŒ ะฟะพะณั€ัƒะถะฐั‚ัŒัั ะฒ ะทะฐั…ะฒะฐั‚ั‹ะฒะฐัŽั‰ะธะน ะผะธั€ ะพะฝะปะฐะนะฝ-ะบะฐะทะธะฝะพ Riobet!

ะ’ ัั‚ะพะผ ะฟะพะดั€ะพะฑะฝะพะผ ั€ัƒะบะพะฒะพะดัั‚ะฒะต ะผั‹ ั€ะฐััะผะพั‚ั€ะตะปะธ ะฒัะต ะฝะตะพะฑั…ะพะดะธะผั‹ะต ัˆะฐะณะธ, ั‡ั‚ะพะฑั‹ ะฝะฐั‡ะฐั‚ัŒ ะธะณั€ะฐั‚ัŒ ะฒ Riobet ะบะฐะทะธะฝะพ ะดะปั ั€ะพััะธัะฝ. ะœั‹ ะพะทะฝะฐะบะพะผะธะปะธััŒ ั ะฟั€ะพั†ะตััะพะผ ั€ะตะณะธัั‚ั€ะฐั†ะธะธ, ะฟะพะฟะพะปะฝะตะฝะธั ัั‡ะตั‚ะฐ ะธ ะฒั‹ะฑะพั€ะพะผ ะธะณั€. ะขะตะฟะตั€ัŒ, ะบะพะณะดะฐ ะฒั‹ ะทะฝะฐะตั‚ะต, ะบะฐะบ ะฝะฐั‡ะฐั‚ัŒ, ะฝะต ั‚ะตั€ัะนั‚ะต ะฒั€ะตะผั ะธ ะฟั€ะธัะพะตะดะธะฝัะนั‚ะตััŒ ะบ ะทะฐั…ะฒะฐั‚ั‹ะฒะฐัŽั‰ะตะผัƒ ะผะธั€ัƒ ะพะฝะปะฐะนะฝ-ะบะฐะทะธะฝะพ Riobet. ะฃะดะฐั‡ะธ ะฒ ะธะณั€ะต ะธ ะฟั€ะธัั‚ะฝะพะณะพ ะฒั€ะตะผัะฟั€ะพะฒะพะถะดะตะฝะธั ะฒะผะตัั‚ะต ั Riobet ะบะฐะทะธะฝะพ!

Hereโ€™s a list of the outcomes in post-laser TTTS, from a paper published in 2014. The control group was 47 survivors, aged between 2 and 5 years old (average age 2 years, 4 months).

  • 9% incidence of neurodevelopmental impairment
  • 17% incidence of mild-to-moderate cognitive delay
  • 2% incidence of cerebral palsy
  • 4% incidence of severe cognitive delay
  • 2% incidence of severe motor delay

We also know that the babies who received transfusions in utero to treat their TAPS had the lowest cognitive scores and that low gestational age at birth and low birth weight were important risk factors for the cognitive delays.

Spontaneous TAPS

Spontaneous TAPS is a little more common, in that it happens in around 3-5% of pregnancies.

What do we know about the long-term effects of Spontaneous TAPS?

For a long time, they were thought to be much the same as post-laser TAPS. In a paper thatโ€™s about to be published though, this has been shown to be incorrect.

Spontaneous TAPS has much more serious, much more devastating consequences than post-laser TAPS.

We know this control group is much larger and has intensive follow-ups. In fact, what we also know is that this group is the largest known group of TAPS survivors in the world. They are followed intensively, and this group is almost double that of the post-laser group used in 2014.

The control group of 74 survivors was assessed at an average age of 4 years old (but ages ranged from 2 years to 7+ years).

Hereโ€™s the facts on the information so far from this study:

Neurodevelopmental impairment

  • Neurodevelopmental impairment was detected in 31% of the total group
  • 44% of donors had neurodevelopmental impairment
  • 4.1 higher risk than recipients
  • 18% of recipients had neurodevelopmental impairment
  • Severe neurodevelopmental impairment occurred in 9% of the total group
  • 18% of donors had severe neurodevelopmental impairment
  • 3% of recipients had severe neurodevelopmental impairment
  • Mild-to-moderate neurodevelopmental impairment was found in 20% of the total group
  • 26% of donors had mild-to-moderate neurodevelopmental impairment
  • 15% of recipients had mild-to-moderate neurodevelopmental impairment
  • Donors had significantly lower cognitive scores compared to recipients

Hearing issues

long term effects of TAPS

Other concerns

  • Behavioral problems were reported in 10% of the total group
  • No difference between donors and recipients
  • Parents expressed significantly more developmental concerns about donors
  • Neurodevelopmental impairment was significantly associated with severe fetal anemia, being the donor, severe fetal growth restriction, and low gestational age at birth
  • Donors with severe fetal anemia had a 6-fold increased risk for neurodevelopmental impairment
  • Spontaneous TAPS survivors show more detrimental outcomes than post-laser TAPS survivors

Objections

We know that some people are dismissing the spontaneous outcomes because the control group is too small and that these are normal premature related issues (with particular reference to the delays and deafness).

Weโ€™d like to rebut that.

Firstly, the control group for spontaneous TAPS is the largest known in the world. A lack of diagnosis and recognition for TAPS has limited the number of cases that are able to be followed up. What weโ€™d also like to ask is why the smaller, post-laser group follow-up number is deemed acceptable, where the larger, heavily investigated spontaneous group outcomes are being dismissed?

Secondly, whilst delays and hearing issues are related to prematurity, they are documented at much higher rates in TAPS twins, and at alarming rates in donor twins only. If the data was only prematurity related, wouldnโ€™t we see an even diagnosis across the board, rather than a higher incidence in donors?

We spoke with an audiologist who confirmed that there is a possible link between ANSD and prematurity (however, the information here is also limited as research into ANSD is new, and a rather uncommon diagnosis), and they confirmed what weโ€™ve stated here โ€“ that if bilateral deafness was only a prematurity related issue, it would occur equally in donors and recipients, and not only in donors.

What we donโ€™t know.

One of the biggest things about TAPS is we have to remember is this disease is literally just 15 years old when it comes to naming and recognition. The long-term effects are just only becoming known, and so itโ€™s important that we remember that this data, while it will help us advocate and get appropriate care for our babies, can, and probably will change.

As TAPS becomes more and more recognized, and more long-term studies are completed, we will see changes to these outcomes โ€“ this is certain. For now, this data is a start, and it is more information than we have ever had.

We do have the hurdle that these control groups are small, and for definite answers, we do need larger groups to study and test. This is one of the reasons that websites like TAPS Registry existed โ€“ to pool data and increase the range of the studies. We also think this is a great time to point out that you are the voice for your children โ€“ advocate for prenatal and post-natal TAPS testing, and childhood follow-ups.

What we do know.

We do know that whilst the group is small, these outcomes are shocking. Spontaneous TAPS is devastating, and clearly, diagnosis and intervention are crucial to lowering the risks.

What we also know is that this information now helps parents to get intervention for the babies born with spontaneous TAPS. We now have some data to help us get early intervention and assistance that we critically need.

What we also have is a reason to advocate hard for MCA dopplers and TAPS Awareness. The outcomes have been crucial to our fight for getting MCA dopplers made a standard part of testing for monochorionic twins. If we know the outcomes, we can push for testing and diagnosis, and more importantly, treatment to avoid them.

How you can advocate.

โ€ข Get routine MCA-PSV Dopplers while pregnant
โ€ข Hemoglobin and reticulocytes for both babies must be done at birth (even if you were having routine MCA-PSV Dopplers while pregnant)
โ€ข Your placenta must be sent to pathology to be evaluated for TAPS anastomoses – dye injection is vital!
โ€ข Get proper ante and postnatal TAPS treatment(s), when possible
โ€ข Make sure your pediatrician and other health care providers are on-board for routine long-term follow-up to screen for the complications outlined above
โ€ข Be proactive about childhood intervention(s)
โ€ข Always ask questions.

Donโ€™t accept the outdated excuses, and fight the myths about TAPS. Donโ€™t let anyone dismiss your concerns or your right to a basic standard of care.

If you have a diagnosis and want to talk to others in the same boat, or you want to ask more questions, you can join our Facebook group, or just contact us. Weโ€™re here for you.

Sources:

Slaghekke, F., van Klink, J. M. M., Koopman, H. M., Middeldorp, J. M., Oepkes, D., & Lopriore, E. (2014). Neurodevelopmental outcome in twin anemiaโ€“polycythemia sequence after laser surgery for twinโ€“twin transfusion syndrome. Ultrasound in Obstetrics & Gynecology, 44(3), 316-321.

Tollenaar, L. S. A., Lopriore, E., Slaghekke, F., Oepkes, D., Middeldorp, J. M., Haak, M. C., โ€ฆ & Van Klink, J. M. M. (2019). High risk of longโ€term impairment in donor twins with spontaneous twin anemia polycythemia sequence. Ultrasound in Obstetrics & Gynecology

Updated 29/07/2021. Links checked and updated..