Whitworth N S, Magann E F, Morrison J C
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, USA.
Am J Obstet Gynecol. 1999 Jun;180(6 Pt 1):1438-41. doi: 10.1016/s0002-9378(99)70032-3.
This study was undertaken to evaluate the correspondence in fetal lung development between diamniotic twins.
Lecithin/sphingomyelin ratios were determined for amniotic fluid specimens collected from each sac in 58 diamniotic twin pregnancies.
Overall, the lecithin/sphingomyelin ratios of twin A and twin B and those of the larger and smaller twins of each pair were closely correlated (r >/= 0.83, P <.001). When stratified by gestational age, however, the percentage disparity in lecithin/sphingomyelin ratios between members of twin pairs was significantly greater at </=32 weeks' gestation (25%) than at >32 weeks' gestation (15%, P =.027). An analysis of the lecithin/sphingomyelin ratios of twins with a large lecithin/sphingomyelin ratio disparity (>/=20%) suggested that this disparity was a result of 1 twin having a lecithin/sphingomyelin ratio that was advanced for gestational age with respect to that of the co-twin. Disparities in lecithin/sphingomyelin ratio were not significantly affected by fetal sex or by discordance in size between the twins.
At relatively early stages of diamniotic twin gestation (</=32 weeks' gestation), lecithin/sphingomyelin ratios should be obtained for both amniotic sacs to ensure accurate assessment of fetal lung maturity in both twins.
本研究旨在评估双羊膜囊双胎胎儿肺发育的一致性。
对58例双羊膜囊双胎妊娠中从每个羊膜囊中采集的羊水标本测定卵磷脂/鞘磷脂比值。
总体而言，双胎A和双胎B以及每对较大和较小双胎的卵磷脂/鞘磷脂比值密切相关（r≥0.83，P<0.001）。然而，按孕周分层时，双胎成员间卵磷脂/鞘磷脂比值的差异百分比在孕周≤32周时（25%）显著大于孕周>32周时（15%，P=0.027）。对卵磷脂/鞘磷脂比值差异较大（≥20%）的双胎的卵磷脂/鞘磷脂比值分析表明，这种差异是由于一个双胎的卵磷脂/鞘磷脂比值相对于其双胎在孕周方面提前所致。卵磷脂/鞘磷脂比值的差异不受胎儿性别或双胎间大小不一致的显著影响。
在双羊膜囊双胎妊娠的相对早期阶段（孕周≤32周），应获取两个羊膜囊的卵磷脂/鞘磷脂比值，以确保准确评估两个胎儿的肺成熟度。
