Twin anemia-polycythemia sequence (TAPS) is a rare condition in monochorionic twin pregnancies. Small intertwin placental vascular communications allow transfusion, which results in a hemoglobin difference in the twins in the absence of oligohydramnios or polyhydramnios. We report here a case of TAPS diagnosed at 17 weeks’ gestation in an obese patient (BMI 42) with a whole anterior placenta. The only possible treatment at this stage of pregnancy was intra-uterine transfusion (IUT), which was repeated weekly until photocoagulation of placental anastomoses was feasible. Fetoscopic laser surgery is the only curative treatment, but is challenging in TAPS because of the absence of polyhydramnios and the presence of minuscule anastomoses. An anterior placenta and high BMI can make the procedure even more challenging. This case report demonstrates that very early and rapidly progressing TAPS with technically complicated conditions (elevated BMI and anterior placenta) can be successfully managed with IUT until laser procedure is achievable.

The C++// language (pronounced C++parallel) was designed and implemented with the aim of importing reusability into parallel and concurrent programming, in the framework of a mimd model. From a reduced set of rather simple primitives, comprehensive and versatile libraries are defined. In the absence of any syntactical extension, the C++// user writes standard C++ code. The libraries are themselves extensible by the final users, making C++// an open system. Two specific techniques to improve performances of a distributed object language such as C++// are then presented: Shared-on-Read and Overlapping of Communication and Computation. The appliance of those techniques is guided by the programmer at a very high-level of abstraction, so the additional work to yield those good performance improvements is kept to the minimum.