Matsuda Yoshio, Kouno Satoshi
Department of Obstetrics and Gynecology, Kagoshima City Hospital, Kagoshima, Japan.
Fetal Diagn Ther. 2002 Sep-Oct;17(5):268-71. doi: 10.1159/000063177.
The purpose of this study was to review consecutive pregnancies complicated by twin oligohydramnios-polyhydramnios sequence (TOPS) and to clarify the probable factors influencing the perinatal outcomes.
Twenty-five pregnancies with a diagnosis of TOPS were treated with and without amniocentesis. A poor perinatal outcome was defined when either perinatal mortality or cerebral palsy was observed.
The mean gestational age at the time of diagnosis and of delivery was 27.8 (range 21-34) and 30.7 (range 23-35) weeks, respectively. Tocolytic therapy and therapeutic amniocentesis were done in 16 (64%) and 13 (52%) cases. Hydrops fetalis was present in 10 cases. The survival rate was 72%, and cerebral palsy was diagnosed in 8 of 36 infants (22%). The poor prognostic factors were gestational age at delivery (<30 weeks) and presence of symptomatic preterm labor and hydrops fetalis. Therapeutic amniocentesis did not influence the perinatal outcome.
In this observational study, the long-term as well as the short-term perinatal outcome of pregnancy with TOPS seems to be poor. In addition, therapeutic amniocentesis in TOPS does not appear to affect fetal and neonatal outcomes.
本研究旨在回顾连续妊娠合并双胎羊水过少-羊水过多序列征（TOPS）的情况，并阐明影响围产期结局的可能因素。
25例诊断为TOPS的妊娠患者接受了羊膜腔穿刺术和未接受羊膜腔穿刺术的治疗。当观察到围产期死亡或脑瘫时，定义为围产期结局不良。
诊断时和分娩时的平均孕周分别为27.8周（范围21 - 34周）和30.7周（范围23 - 35周）。16例（64%）进行了宫缩抑制剂治疗，13例（52%）进行了治疗性羊膜腔穿刺术。10例出现胎儿水肿。存活率为72%，36例婴儿中有8例（22%）被诊断为脑瘫。不良预后因素为分娩时孕周（<30周）、有症状的早产和胎儿水肿。治疗性羊膜腔穿刺术未影响围产期结局。
在这项观察性研究中，TOPS妊娠的短期和长期围产期结局似乎都很差。此外，TOPS中的治疗性羊膜腔穿刺术似乎不会影响胎儿和新生儿结局。
