Arabin Birgit
Isala Clinics and Clara Angela Foundation, Zwolle, The Netherlands.
Fetal Diagn Ther. 2009;25(1):173-6. doi: 10.1159/000210081. Epub 2009 Mar 31.
It is the aim of this study to report on the prenatal diagnosis and course of a spontaneous monochorionic (MC) 5-amniotic (5A) quintuplet pregnancy which is such a rare event that it has up to now never been described antenatally.
A spontaneous MC 5A quintuplet pregnancy was diagnosed at 12 weeks by 2D ultrasound. Video tapes (2D and 4D) were made showing that 2D ultrasound still better documented simultaneous visualization of all quintuplets including their activities compared with 4D ultrasound, which, however, adds the information of space location. Variances of crown-rump length, nuchal translucency and nasal bone were evaluated. After informed consent and a second opinion of 2 centers performing invasive laser coagulation or occlusion of the umbilical cord, the parents decided to interrupt pregnancy. Pathologic evaluation confirmed MC 5A quintuplet pregnancy.
The case demonstrates that splitting of 1 zygote into 5 embryos might even occur spontaneously. In view of the poor outcome and limited success of fetal reduction, pregnancy termination was finally part of the counseling.
本研究旨在报告一例自然受孕的单绒毛膜五羊膜囊五胞胎妊娠的产前诊断及过程，这是一种极为罕见的情况，迄今为止尚未有产前描述。
孕12周时通过二维超声诊断出一例自然受孕的单绒毛膜五羊膜囊五胞胎妊娠。制作了录像带（二维和四维），结果显示与四维超声相比，二维超声在记录所有五胞胎同时显影及其活动方面仍更具优势，不过四维超声增加了空间位置信息。评估了顶臀长、颈项透明层厚度及鼻骨的差异。在获得知情同意并经两个进行侵入性激光凝固或脐带闭塞术的中心会诊后，父母决定终止妊娠。病理评估证实为单绒毛膜五羊膜囊五胞胎妊娠。
该病例表明，一个受精卵甚至可能自然分裂为5个胚胎。鉴于减胎术效果不佳且成功率有限，终止妊娠最终成为咨询内容的一部分。
