Woo H H, Sin S Y, Tang L C
Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong.
Hong Kong Med J. 2000 Sep;6(3):293-300.
To review the maternal and neonatal outcomes, and management of single foetal death in twin pregnancies.
Medline literature search (1950 to 1999) and hospital audit of single antepartum foetal deaths in twin pregnancy from 1993 through 1997.
Key words for literature search: twin pregnancy/pregnancies; single fetal death/demise.
Data were extracted and reviewed independently by the authors.
During the study period, 182 (0.76%) of 23,804 deliveries involved twin pregnancies. Seven (3.8%) of the twin pregnancies were complicated by the death of one foetus. Single foetal death in a twin pregnancy in the late second and third trimesters is associated with significant morbidity and mortality in the surviving co-twin, especially in a pregnancy involving monochorionic twins. Management should be individualised; conservative management is preferred by most obstetricians.
Single foetal death in twin pregnancies should be managed in a tertiary referral centre, where intensive foetal surveillance and adequate neonatal support are available. A multidisciplinary approach should be adopted.
回顾双胎妊娠中单胎胎儿死亡的母儿结局及处理方法。
1950年至1999年的Medline文献检索以及1993年至1997年双胎妊娠产前单胎胎儿死亡的医院审计。
文献检索关键词：双胎妊娠；单胎胎儿死亡/死亡。
作者独立提取并审查资料。
在研究期间，23,804例分娩中有182例（0.76%）为双胎妊娠。其中7例（3.8%）双胎妊娠合并单胎胎儿死亡。孕晚期双胎妊娠中单胎胎儿死亡与存活的另一胎儿的显著发病率和死亡率相关，尤其是在单绒毛膜双胎妊娠中。处理应个体化；大多数产科医生倾向于保守处理。
双胎妊娠中单胎胎儿死亡应在具备强化胎儿监测和充分新生儿支持的三级转诊中心处理。应采用多学科方法。
