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双胎妊娠中的卵黄囊

[Yolk sacs in twin pregnancy].

作者信息

Malinowski W

机构信息

Oddziału Połozniczo-Ginekologicznego Szpitala im. A. Troczewskiego w Kutnie.

出版信息

Ginekol Pol. 2000 Aug;71(8):815-8.

Abstract

The purpose of this study was to evaluate the relationship between the yolk sacs separated or not separated by septum and chorionicity twin pregnancies scanned early in the first trimester. Moreover, to determine the relation between size and morphologic features of the yolk sac and outcome twin pregnancy. Twenty four of 38 spontaneous twin pregnancies were dichorionic, eight--monochorionic diamniotic, five monochorionic twin gestations with discordant sizes and views of yolk sacs, and one a twin ectopic pregnancy (underwent salpingectomy). In all 38 sets of twin two yolk sacs were identified. During the first trimester of dichorionic twin pregnancy, the yolk sacs were always separated by a septum and not separated ("Eight" sign) in monochorionic twin pregnancy. In five cases, one of yolk sacs was abnormally large (> 8 mm) and had thinner wall. Three (all MC) of the five mothers spontaneously aborted during the next 2-3 weeks. In one case of monochorionic twin ectopic pregnancy two yolk sacs were seen normally. The sonographic identification of yolk sacs allows a reliable and simple determination chorionicity twin pregnancy. Moreover, visualization of large size (> 8 mm) of yolk sac can be used as a predictor of abnormal outcome pregnancy.

摘要

本研究的目的是评估孕早期扫描的双绒毛膜双胎妊娠中,卵黄囊是否被隔膜分隔与绒毛膜性之间的关系。此外,确定卵黄囊的大小和形态特征与双胎妊娠结局之间的关系。38例自然双胎妊娠中,24例为双绒毛膜,8例为单绒毛膜双羊膜囊,5例为单绒毛膜双胎妊娠,卵黄囊大小和形态不一致,1例为双胎异位妊娠(接受了输卵管切除术)。在所有38对双胎中均识别出两个卵黄囊。在双绒毛膜双胎妊娠的孕早期,卵黄囊总是被隔膜分隔,而在单绒毛膜双胎妊娠中则未被分隔(“8”字征)。5例中,有1个卵黄囊异常大(>8mm)且壁薄。这五位母亲中有三位(均为单绒毛膜双胎)在接下来的2至3周内自然流产。在1例单绒毛膜双胎异位妊娠中,正常可见两个卵黄囊。超声识别卵黄囊可对双胎妊娠的绒毛膜性进行可靠且简单的判定。此外,卵黄囊大尺寸(>8mm)的可视化可作为妊娠异常结局的预测指标。

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