Kordek Agnieszka, Pawlus Beata, Loniewska Beata, Zebiełowicz Dariusz, Rudnicki Jacek, Czajka Ryszard
Katedra i Klinika Połoznictwa i Perinatologii, PAM w Szczecinie.
Med Wieku Rozwoj. 2003 Jul-Sep;7(3 Suppl 1):217-22.
Twin-to-twin transfusion syndrome is one of the complications during bigeminal pregnancy usually seen between 17 and 31 weeks of gestation. The most typical symptoms of twin-to-twin transfusion are ascites, hydropericardium and generalized hydrops of donors fetus. Characteristic is also difference of body weight over 15% and hemoglobin level more than 5 g/dl between twins. The mortality rate of donors is very high approaching 50%. In this case report we found some features of twin-to-twin transfusion: time of delivery--33 weeks of gestation, mode of delivery--cesarean section, generalized hydrops of the donor. The clinical status of donors was critical--Apgar score 1-1-1. The hemoglobin level was extremely low--3.2 g/dl. The rescue treatment was not successful and donors twin died. Clinical problems of second twin was also common: polycythaemia, hypoglycaemia and hyperbilirubinaemia.
双胎输血综合征是双胎妊娠期间的并发症之一,通常发生在妊娠17至31周之间。双胎输血最典型的症状是受血胎儿出现腹水、心包积液和全身水肿。双胎之间体重差异超过15%且血红蛋白水平相差超过5 g/dl也是其特征。供血胎儿的死亡率非常高,接近50%。在本病例报告中,我们发现了双胎输血的一些特征:分娩时间——妊娠33周,分娩方式——剖宫产,供血胎儿全身水肿。供血胎儿的临床状况危急——阿氏评分1-1-1。血红蛋白水平极低——3.2 g/dl。抢救治疗未成功,供血胎儿死亡。第二个胎儿也常见临床问题:红细胞增多症、低血糖和高胆红素血症。