Colla F, Alba E, Grio R
Dipartimento di Discipline Ginecologichee Ostetriche, Cattedra B, Università degli Studi, Turin, Italy.
Minerva Ginecol. 2001 Apr;53(2):113-20.
Embryo-fetal diseases are the consequence of prenatal (progenetic and metagenetic or environmental) and intranatal (of a traumatic, infective, toxic nature) pathological factors. In multiple pregnancies this complex etiopathogenesis also includes an altered didymous embriogenesis. This study aimed to evaluate the pathologies affecting the fetus in multiple pregnancy, a special biological situation leading to the potential onset of severe fetal and neonatal damage.
The authors studied 205 patients with multiple pregnancies, including 199 bigeminal, 5 trigeminal and 1 quadrigeminal, admitted to the Department B of the Obstetrics and Gynecological Clinic of Turin University between 1989-1999. Possible embyro-fetal damage was examined using a chronological criterion: namely following the development of the multiple fetuses from the zygotic to the neonatal phase.
Pregnancies were biamniotic bichorionic in 54% of cases, biamniotic monochorionic in 45% and monochorionic monoamniotic in 1%. There were a total of 154 (79.38%) premature births out of 194 and neonatal birth weight was always SGA (small for gestational age). 66.84% of newborns were LBW (<2500 g) and 7.14% were VLBW (<1500 g). Fetal mortality (2.29%) was higher than early neonatal mortality (1.53%). Perinatal mortality (3.82%) was three times higher than in all neonates from the same period (1.03%).
The severe embryo-fetal and neonatal damage found in multiple pregnancies is a clinical reality that calls for adequate diagnostic and therapeutic measures, and above all specific medical and social prevention to limit maternal pathogenic risks.
胚胎 - 胎儿疾病是产前（遗传、后生或环境因素）和产时（创伤性、感染性、毒性因素）病理因素导致的结果。在多胎妊娠中，这种复杂的病因还包括双胎胚胎发育异常。本研究旨在评估多胎妊娠中影响胎儿的病理情况，这是一种特殊的生物学状况，可能导致严重的胎儿和新生儿损伤。
作者研究了1989年至1999年间收治于都灵大学妇产科诊所B科的205例多胎妊娠患者，其中包括199例双胎、5例三胎和1例四胎。采用时间顺序标准检查可能的胚胎 - 胎儿损伤，即追踪多胎胎儿从合子期到新生儿期的发育情况。
54%的病例为双羊膜双绒毛膜妊娠，45%为双羊膜单绒毛膜妊娠，1%为单绒毛膜单羊膜妊娠。194例中有154例（79.38%）早产，新生儿出生体重均为小于胎龄儿（SGA）。66.84%的新生儿为低体重儿（<2500 g），7.14%为极低体重儿（<1500 g）。胎儿死亡率（2.29%）高于早期新生儿死亡率（1.53%）。围产期死亡率（3.82%）是同期所有新生儿死亡率（1.03%）的三倍。
多胎妊娠中发现的严重胚胎 - 胎儿和新生儿损伤是一个临床现实，需要采取适当的诊断和治疗措施，最重要的是进行具体的医学和社会预防，以降低母体致病风险。
