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中华产科急救电子杂志 ›› 2019, Vol. 08 ›› Issue (01) : 27 -31. doi: 10.3877/cma.j.issn.2095-3259.2019.01.007

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复杂性双胎妊娠超声诊断及孕期监测
陈兢思1,(), 刘予1   
  1. 1. 510150 广州医科大学附属第三医院产前诊断科
  • 收稿日期:2018-11-02 出版日期:2019-02-18
  • 通信作者: 陈兢思
  • 基金资助:
    国家重点研发计划(2018YFC1002900); 国家自然科学基金重点项目(81830045)

Ultrasound diagnosis and pregnancy monitoring of complicated twin pregnancy

Jingsi Chen1(), Yu Liu1   

  • Received:2018-11-02 Published:2019-02-18
  • Corresponding author: Jingsi Chen
引用本文:

陈兢思, 刘予. 复杂性双胎妊娠超声诊断及孕期监测[J]. 中华产科急救电子杂志, 2019, 08(01): 27-31.

Jingsi Chen, Yu Liu. Ultrasound diagnosis and pregnancy monitoring of complicated twin pregnancy[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2019, 08(01): 27-31.

复杂性双胎严重影响围产儿出生质量及预后,而利用超声对复杂性双胎进行诊断及评估既安全又可靠。如何在众多双胎妊娠中识别、诊断复杂性双胎,并对其进行有效孕期监护和及时处理,是改善复杂性双胎妊娠的预后及降低缺陷出生的关键所在。

With the change of fertility policy and the rapid development of reproductive technology, the number of twin pregnancies was increasing. Complicated twins play a serious effort on the perinatal quality and prognosis. Ultrasound was the only safe and reliable method for the diagnosis and evaluation of complicated twins. How to identify, diagnose, monitor and deal with complex twins in many twin pregnancies was the key to improve the prognosis of complicated twin pregnancies and reduce the birth defects.

表1 TTTS的Quintero分期[9]
表2 TAPS的产前诊断分期[3]
表3 TRAP的分型[3]
[1]
Heyborne KD,Porreco RP,Garite TJ, et al. Improved perinatal survival of monoamniotic twins with intensive inpatient monitoring [J]. Am J Obstet Gynecol, 2005; 192(1): 96-101.
[2]
Collaborative Southwest Thames Obstetric Research, Prospective risk of late stillbirth in monochorionic twins: a regional cohort study [J]. Ultrasound Obstet Gynecol, 2012, 39(5): 500-504.
[3]
Khalil A,Rodgers M,Baschat A, et al. ISUOG Practice Guidelines: role of ultrasound in twin pregnancy [J]. Ultrasound Obstet Gynecol, 2016, 47(2): 247-263.
[4]
Morin L,Lim K. No. 260-Ultrasound in Twin Pregnancies [J]. J Obstet Gynaecol Can, 2017, 39(10): e398-e411.
[5]
Monteagudo A,Roman AS. Ultrasound in multiple gestations: twins and other multifetal pregnancies [J]. Clin Perinatol, 2005, 32(2): 329-354, vi.
[6]
Bromley B,Benacerraf B. Using the number of yolk sacs to determine amnionicity in early first trimester monochorionic twins [J]. J Ultrasound Med, 1995; 14(6): 415-419.
[7]
Stenhouse E,Hardwick C,Maharaj S, et al. Chorionicity determination in twin pregnancies: how accurate are we? [J]. Ultrasound Obstet Gynecol, 2002, 19(4): 350-352.
[8]
Moldenhauer JS,Johnson MP. Diagnosis and Management of Complicated Monochorionic Twins [J]. Clin Obstet Gynecol, 2015, 58(3): 632-642.
[9]
Quintero RA,Morales WJ,Allen MH, et al. Staging of twin-twin transfusion syndrome [J]. J Perinatol, 1999, 19(8 Pt 1): 550-555.
[10]
Van Mieghem T,Lewi L,Gucciardo L, et al. The Fetal Heart in Twin-to-Twin Transfusion Syndrome [J]. Int J Pediatr, 2010, 2010. pii: 379792.
[11]
Weisz B,Hoffmann C,Ben-Baruch S, et al. Early detection by diffusion-weighted sequence magnetic resonance imaging of severe brain lesions after fetoscopic laser coagulation for twin-twin transfusion syndrome [J]. Ultrasound Obstet Gynecol, 2014, 44(1): 44-49.
[12]
Lewi L,Valencia C,Gonzalez E, et al. The outcome of twin reversed arterial perfusion sequence diagnosed in the first trimester [J]. Am J Obstet Gynecol, 2010, 203(3): 213 e211-214.
[13]
Moore TR,Gale S,Benirschke K. Perinatal outcome of forty-nine pregnancies complicated by acardiac twinning [J]. Am J Obstet Gynecol, 1990, 163(3): 907-912.
[14]
Lee H,Bebbington M,Crombleholme TM, et al. The North American Fetal Therapy Network Registry data on outcomes of radiofrequency ablation for twin-reversed arterial perfusion sequence [J]. Fetal Diagn Ther, 2013, 33(4): 224-229.
[15]
Oliver ER,Coleman BG,Goff DA, et al. Twin reversed arterial perfusion sequence: a new method of parabiotic twin mass estimation correlated with pump twin compromise [J]. J Ultrasound Med, 2013, 32(12): 2115-2123.
[16]
Jelin E,Hirose S,Rand L, et al. Perinatal outcome of conservative management versus fetal intervention for twin reversed arterial perfusion sequence with a small acardiac twin [J]. Fetal Diagn Ther, 2010, 27(3): 138-141.
[17]
Prefumo F,Fichera A,Pagani G, et al. The natural history of monoamniotic twin pregnancies: a case series and systematic review of the literature [J]. Prenat Diagn, 2015, 35(3): 274-280.
[18]
Kalish RB,Thaler HT,Chasen ST, et al. First- and second-trimester ultrasound assessment of gestational age [J]. Am J Obstet Gynecol, 2004, 191(3): 975-978.
[19]
Khalil A,D′Antonio F,Dias T, et al. Thilaganathan, and Collaborative Southwest Thames Obstetric Research, Ultrasound estimation of birth weight in twin pregnancy: comparison of biometry algorithms in the STORK multiple pregnancy cohort [J]. Ultrasound Obstet Gynecol, 2014, 44(2): 210-220.
[20]
Obstetricians American College of, Gynecologists, and Medicine Society for Maternal-Fetal, ACOG Practice Bulletin No. 144: Multifetal gestations: twin, triplet, and higher-order multifetal pregnancies [J]. Obstet Gynecol, 2014, 123(5): 1118-1132.
[21]
D′Antonio F,Khalil A,Morlando M. Thilaganathan, Accuracy of Predicting Fetal Loss in Twin Pregnancies Using Gestational Age-Dependent Weight Discordance Cut-Offs: Analysis of the STORK Multiple Pregnancy Cohort [J]. Fetal Diagn Ther, 2015, 38(1): 22-28.
[22]
Hall JG. Twinning [J]. Lancet, 2003, 362(9385): 735-743.
[23]
Lewi L,Jani J,Blickstein I, 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): 511-518.
[24]
Baxi LV,Walsh CA. Monoamniotic twins in contemporary practice: a single-center study of perinatal outcomes [J]. J Matern Fetal Neonatal Med, 2010, 23(6): 506-510.
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