Lopriore Enrico, Sueters Marieke, Middeldorp Johanna M, Oepkes Dick, Vandenbussche Frank P, Walther Frans J
Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
J Pediatr. 2005 Nov;147(5):597-602. doi: 10.1016/j.jpeds.2005.06.004.
To determine neonatal mortality and morbidity rates in monochorionic twins with chronic twin-to-twin transfusion syndrome (TTTS) treated with fetoscopic laser occlusion of vascular anastomoses.
In a prospective study of monochorionic twins delivered at our center between June 2002 and December 2004, neonatal outcome was assessed in 40 monochorionic twin pairs with TTTS treated with laser compared with 46 monochorionic twin pairs without TTTS.
The neonatal mortality rate in the TTTS and no-TTTS group was 8% (6/76) and 3% (3/90), respectively. The rate of severe cerebral lesions on ultrasound scanning in the TTTS and no-TTTS group was 14% (10/72) and 6% (5/82), respectively. The incidence of adverse neonatal outcome (neonatal death, major neonatal morbidity, or severe cerebral lesions) in the TTTS and no-TTTS group was, respectively, 26% (20/76) and 13% (12/90) (RR = 1.97, 95% CI = 1.03 to 3.77).
Although perinatal outcome in TTTS has improved after laser therapy, neonatal mortality and morbidity rates remain high. Relative risk for adverse neonatal outcome is increased 2-fold in TTTS treated with laser relative to monochorionic twins without TTTS.
确定采用胎儿镜激光封堵血管吻合术治疗的单绒毛膜双胎慢性双胎输血综合征（TTTS）的新生儿死亡率和发病率。
在一项对2002年6月至2004年12月在我们中心分娩的单绒毛膜双胎的前瞻性研究中，对40例接受激光治疗的TTTS单绒毛膜双胎与46例未患TTTS的单绒毛膜双胎的新生儿结局进行评估。
TTTS组和非TTTS组的新生儿死亡率分别为8%（6/76）和3%（3/90）。TTTS组和非TTTS组超声扫描显示的严重脑损伤发生率分别为14%（10/72）和6%（5/82）。TTTS组和非TTTS组不良新生儿结局（新生儿死亡、主要新生儿疾病或严重脑损伤）的发生率分别为26%（20/76）和13%（12/90）（相对危险度=1.97，95%可信区间=1.03至3.77）。
尽管激光治疗后TTTS的围产期结局有所改善，但新生儿死亡率和发病率仍然很高。与未患TTTS的单绒毛膜双胎相比，接受激光治疗的TTTS新生儿出现不良结局的相对风险增加了2倍。
