Malinowski Witold
Oddziału Połozniczo-Ginekologicznego Szpitala im. A. Troczewskiego w Kutnie.
Ginekol Pol. 2002 Sep;73(9):763-70.
The aim of the study was to compare the reliability of chorionicity determination in twin pregnancy using different ultrasonographic methods as compared with post-partum placental assessment.
The study included 262 spontaneous twin pregnancies delivered at Kutno Hospital between 1989 and 1996. All twin gestations were diagnosed by sonography by the 28-th week's gestation. The ultrasonographic and pathologic correlation between the chorionic and amniotic type was assessed in this group.
The ultrasonographic evaluation of the 262 spontaneous twin gestations demonstrated 181 (69.1%) dichorionic and 81 (30.9%) monochorionic twin pregnancies. Three of monochorionic twins were monoamniotic. In all 262 transvaginal and abdominal ultrasonography correctly predicted the chorionic and amniotic type as determined by the pathologic findings.
Ultrasonography before the 28-th week can accurately determine the chorionic and amniotic type in twin pregnancies. The determination of chorionicity during the first half of pregnancy should be based on the various signs. In the second half of pregnancy, the obstetrician should rely on fetal sex in combination with the number of placentas, and characteristics of the dividing membrane.
本研究旨在比较使用不同超声检查方法确定双胎妊娠绒毛膜性的可靠性，并与产后胎盘评估结果进行对比。
本研究纳入了1989年至1996年间在库特诺医院分娩的262例自然双胎妊娠。所有双胎妊娠均在妊娠28周时通过超声检查确诊。对该组病例评估绒毛膜性和羊膜性的超声检查结果与病理结果之间的相关性。
对262例自然双胎妊娠进行超声检查评估显示，181例（69.1%）为双绒毛膜双胎妊娠，81例（30.9%）为单绒毛膜双胎妊娠。单绒毛膜双胎中有3例为单羊膜囊双胎。在所有262例病例中，经阴道和腹部超声检查均正确预测了病理检查所确定的绒毛膜性和羊膜性。
妊娠28周前超声检查可准确确定双胎妊娠的绒毛膜性和羊膜性。妊娠前半期绒毛膜性的确定应基于多种征象。妊娠后半期，产科医生应结合胎儿性别、胎盘数量及分隔膜特征进行判断。
