切换至 "中华医学电子期刊资源库"

中华产科急救电子杂志 ›› 2019, Vol. 08 ›› Issue (01) : 5 -9. doi: 10.3877/cma.j.issn.2095-3259.2019.01.002

所属专题: 文献

专家论坛

双胎之一胎死宫内的诊治
黄帅1, 漆洪波1,()   
  1. 1. 400016 重庆医科大学附属第一医院妇产科 重庆市胎儿医学中心
  • 收稿日期:2018-11-01 出版日期:2019-02-18
  • 通信作者: 漆洪波
  • 基金资助:
    国家重点研发计划"生殖健康及重大出生缺陷防控研究"重点专项(2016YFC1000400; 2018YFC100024)

Diagnosis and treatment of single intrauterine fetal death

Shuai Hang1, Hongbo Qi1()   

  • Received:2018-11-01 Published:2019-02-18
  • Corresponding author: Hongbo Qi
引用本文:

黄帅, 漆洪波. 双胎之一胎死宫内的诊治[J]. 中华产科急救电子杂志, 2019, 08(01): 5-9.

Shuai Hang, Hongbo Qi. Diagnosis and treatment of single intrauterine fetal death[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2019, 08(01): 5-9.

随着促排卵技术和辅助生殖技术的发展,多胎妊娠发生率逐年增多。与单胎妊娠相比,多胎妊娠围产儿病死率更高。双胎之一胎死宫内属于双胎妊娠的严重并发症,一胎死亡后会对存活胎儿有潜在、长期的影响,可引起存活胎儿死亡、神经系统损伤、早产及相关后遗症等,因此,孕期应加强母儿监护。及时诊断和处理是改善围产儿结局的关键。

In recent years, with the development of ovulation induction and assisted reproductive technology, the incidence of multiple pregnancy has increased. The perinatal mortality of multiple pregnancies is higher than singleton pregnancies. Single intrauterine fetal death (sIUFD) is one of the most severe complications of twin pregnancy. Single fetal demise has potential and long-term effects on the survival co-twin, including fetal loss, neurovascular injury, premature delivery and related sequelae. Therefore, maternal and fetal monitoring should be strengthened and timely diagnosis and treatment is the key to improve perinatal outcomes.

[1]
高丽丽,杨剑秋. 双胎妊娠一胎胎死宫内研究进展[J]. 协和医学杂志,2015, 6(4): 305-309.
[2]
Fichera A,Zambolo C,Accorsi P, et al. Perinatal outcome and neurological follow up of the cotwin in twin pregnancies complicated by single intrauterine fetal death[J]. Eur J Obstet Gynecol Reprod Biol, 2009, 147(1): 37-40.
[3]
Misra DP,Ananth CV. Infant mortality among singletons and twins in the United States during 2 decades: effects of maternal age [J]. Pediatrics, 2002, 110(6):1163-1168.
[4]
Gul A,Cebeci A,Aslan H, et al. Perinatal outcomes of twin pregnancies discordant for major fetal anomalies [J]. Fetal diagnosis and therapy, 2005, 20(4): 244-248.
[5]
刘秀娟,魏媛,赵杨玉. 单绒毛膜双胎妊娠之一胎死宫内的研究进展[J]. 中华围产医学杂志,2017, 20(4): 256-259.
[6]
Duclos C,Labrecque AA,Codsi E, et al. 416: Twin pregnancy following single fetal death: prognosis of the surviving twin [J]. AJOG, 2016, 214(1): S230.
[7]
Lewi L,Jani J,Blickstein L, et al. The outcome of monochorionic diamniotic twin gestations in the era of invasive fetal therapy: a prospective cohort study [J]. Am J Obstet Gynecol, 2008, 199(5): 514.e1-514.e8.
[8]
Evans MI,Lau TK. Making decisions when no good choices exist: delivery of the survivor after intrauterine death of the co-twin in monochorionic twin pregnancies [J]. Fetal diagnosis and therapy, 2010, 28(4): 191-195.
[9]
Lewi L,Jani J,Blickstein L, et al. The outcome of monochorionic diamniotic twin gestations in the era of invasive fetal therapy: a prospective cohort study [J]. Am J Obstet Gynecol, 2008, 199(5): 514.e1-514.e8.
[10]
Slaghekke F,Kist WJ,Oepkes D, et al. Twin anemia-polycythemia sequence: diagnostic criteria, classification, perinatal management and outcome [J]. Fetal Diagn Ther, 2010, 27(4): 181-190.
[11]
Habli M,Eftekhari N,Wiebracht E, et al. Long-term maternal and subsequent pregnancy outcomes 5 years after hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome [J]. Am J Obstet Gynecol, 2009, 201(4): 385.e1-385.e5.
[12]
van Gemert MJ,van den Wijngaard JP,Vandenbussche FP. Twin reversed arterial perfusion sequence is more common than generally accepted [J]. Birth Defects Res A Clin Mol Teratol, 2015, 103(7): 641-643.
[13]
Lee H,Wagner AJ,Sy E, et al. Efficacy of radiofrequency ablation for twin-reversed arterial perfusion sequence [J]. Am J Obstet Gynecol, 2007, 196(5): 459.e1-459.e4.
[14]
刘海意,王芳,乔福元,等. 双胎妊娠一胎死亡后期待治疗14例分析[J]. 实用妇产科杂志,2006, 22(9): 538-540.
[15]
O′Donoghue K,Rutherford MA,Engineer N, et al. Trnsfusional fetal complications after single intrauterine death in moanochorionic multiple pregnancy are reduced but not prevented by vascular occlusion[J]. BJOG, 2009, 116(6): 804-812.
[16]
林颖,王蕴慧. 双胎之一胎死宫内34例的妊娠结局分析[J]. 中华临床医师杂志,2015, 9(10): 90-94.
[17]
王颖,魏瑗,原鹏波,等. 单绒毛膜双胎之一胎死宫内的共存儿预后分析[J].中华医学杂志,2016, 96(37): 3003-3007.
[18]
Man J,Hutchinson J C,Heazell AE, et al. Stillbirth and intrauterine fetal death: role of routine histopathological placental findings to determine cause of death [J]. Ultrasound Obstet Gynecol, 2016, 48(5): 579-584.
[19]
Evans MI,Lau TK. Making decisions when no good choices exist: delivery of the survivor after intrauterine death of the co-twin in monochorionic twin pregnancies [J]. Fetal Diagn Ther, 2010, 28(4): 191-195.
[20]
杨蕊,赵扬玉,刘平,等.双胎妊娠一胎宫内死亡20例临床分析[J]. 中国优生与遗传杂志,2009, 17(2): 77-79.
[21]
Shek N WM,Hillman SC,Kilby MD. Single-twin demise: pregnancy outcome [J]. Best Pract Res Clin Obstet Gynaecol, 2014, 28(2): 249-263.
[22]
Hillman SC,Morris RK,Kilby MD. Co-twin prognosis after single fetal death: a systematic review and meta-analysis [J]. Obstet Gynecol, 2011, 118(4): 928-940.
[23]
Pharoah PO,Glinianaia SV,Rankin J. Congenital anomalies in multiple births after early loss of a conceptus [J]. Hum Reprod, 2009, 24(3): 726-731.
[24]
Plešinac S,Kotlica BK,Akšam S, et al. Platelet count as a predictive factor of neonatal outcome in twin pregnancy with fetal demise [J]. Clin Exp Obstet Gynecol, 2013, 40(2): 268-270.
[25]
Deveer R,Engin-Ustun Y,Mert I, et al. Twin pregnancies with single fetal death: Analysis of 38 cases [J]. Fetal Pediatr Pathol, 2013, 32(1): 71-75.
[26]
Hillman SC,Morris RK,Kilby MD. Single twin demise: consequence for survivors [J]. Semin Fetal Neonatal Med, 2010, 15(6): 319-326.
[27]
Plesinac S,Kotlica BK,Aksam S. Platelet count as a predictive factor of neonatal outcome in twin pregnancy with fetal demise[J]. Clin Exp Obstet Gynecol, 2013, 40(2): 268-270.
[28]
Jelin AC,Norton ME,Bartha AI, et al. Intracranial magnetic resonance imaging findings in the surviving fetus after spontaneous monochorionic cotwin demise [J]. AJOG, 2008, 199(4): 398.e1-398.e5.
[29]
Hoffmann C,Weisz B,Yinon Y, et al. Diffusion MRI findings in monochorionic twin pregnancies after intrauterine fetal death [J]. AJNR Am J Neuroradiol, 2013, 34(1): 212-216.
[30]
Barigye O,Pasquini L,Galea P, et al. High risk of unexpected late fetal death in monochorionic twins despite intensive ultrasound surveillance: a cohort study [J]. PLoS medicine, 2005, 2(6): 521-526.
[31]
De la Calle Fernández-Miranda M,Bertriu MC,Rodríguez-González R, et al. Twin pregnancy with intrauterine death of one fetus: maternal and neonatal outcome of surviving fetus [J]. Ginecologia y obstetricia de Mexico, 2012, 80(4): 254-262.
[32]
D′antonio F,Thilaganathan B,Dias T, et al. Influence of chorionicity and gestational age at single fetal loss on risk of preterm birth in twin pregnancy: analysis of STORK multiple pregnancy cohort [J]. Ultrasound Obstet Gynecol, 2017, 50(6): 723-727.
[1] 鲁力, 杨小红, 赵胜, 陈欣林. 双胎反向动脉灌注序列征的超声评估指标及病理特征分析[J]. 中华医学超声杂志(电子版), 2019, 16(06): 426-432.
[2] 张爱青, 魏瑗, 张春妤, 刘朝晖, 龚丽君, 王威, 李平, 卢珊, 童春, 种轶文. 双胎之一完全性葡萄胎产前超声特征与临床结局对照分析[J]. 中华医学超声杂志(电子版), 2016, 13(08): 603-608.
[3] 陈甜甜, 王晓东, 余海燕. 双胎妊娠合并Gitelman综合征孕妇的妊娠结局及文献复习[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 559-568.
[4] 张璐, 杨惠娟, 刘凯波. 影响双胎消失综合征存活儿围生期结局危险因素研究[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(04): 400-409.
[5] 李子贤, 李向红, 孙梦雅, 李亮亮, 尹向云, 锡洪敏, 杨萍, 马丽丽. 早产单绒毛膜双胎新生儿坏死性小肠结肠炎临床特点分析及相关文献复习[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(03): 343-349.
[6] 杨璇, 唐军. 双胎输血综合征的诊治及其对新生儿预后影响的研究现状[J]. 中华妇幼临床医学杂志(电子版), 2020, 16(05): 510-518.
[7] 张欢, 贺红菊, 徐敏, 陈杰, 余海燕. 双胎输血综合征胎儿预后[J]. 中华妇幼临床医学杂志(电子版), 2017, 13(02): 139-143.
[8] 林颖. 双胎之一胎死宫内的病因、处理及存活儿的预后[J]. 中华妇幼临床医学杂志(电子版), 2013, 09(03): 388-392.
[9] 杨泽宇, 孙微. 双胎及多胎妊娠胎儿手术围手术期的超声监测[J]. 中华产科急救电子杂志, 2019, 08(01): 22-26.
[10] 郭晓玲. 双胎妊娠染色体异常的产前筛查及产前诊断[J]. 中华产科急救电子杂志, 2019, 08(01): 18-21.
[11] 刘正平. 双胎妊娠分娩时机与分娩方式的选择[J]. 中华产科急救电子杂志, 2019, 08(01): 14-17.
[12] 张晗, 赵扬玉. 复杂性双胎妊娠中射频消融减胎术的应用[J]. 中华产科急救电子杂志, 2019, 08(01): 10-13.
阅读次数
全文


摘要