与序贯性选择性激光手术治疗双胎输血综合征相关的胎儿心率变化。
Fetal heart rate changes associated with sequential selective laser surgery for twin-twin transfusion syndrome.
机构信息
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA.
出版信息
J Perinatol. 2010 Mar;30(3):188-91. doi: 10.1038/jp.2009.151. Epub 2009 Oct 1.
OBJECTIVE
To investigate perioperative changes in fetal heart rate (FHR) associated with sequential vs standard selective laser photocoagulation of communicating vessels for the treatment of twin-twin transfusion syndrome (TTTS).
STUDY DESIGN
Women with TTTS were treated with the intent of using the sequential procedure. Those who failed this treatment were categorized as having undergone the standard procedure. Pre- and postoperative FHR of donor and recipient fetuses were analyzed.
RESULT
Of 98 women, 35 received the standard technique. A postoperative drop in the mean donor FHR was observed in gestations receiving the standard laser, but not in those receiving the sequential technique. In multivariable models that included operative and gestational characteristics, the use of the sequential treatment was associated with improved stability of the FHR of the donor twin.
CONCLUSION
The stability in donor FHR following sequential laser ablation when compared with the standard technique is consistent with improved donor hemodynamics.
目的
探讨与传统选择性激光凝固术（SLT）相比，序贯性 SLT 治疗双胎输血综合征（TTTS）时胎儿心率（FHR）的围手术期变化。
研究设计
本研究中，TTTS 患者接受序贯性 SLT 治疗，若治疗失败则归类为接受传统 SLT 治疗。分析术前和术后供受胎胎儿的 FHR。
结果
98 例孕妇中，35 例接受传统 SLT 治疗。与序贯性 SLT 相比，接受传统 SLT 治疗的孕妇术后供胎 FHR 均值降低。多变量模型中，包括手术和妊娠特征，序贯性治疗与供胎 FHR 稳定性的改善相关。
结论
与传统 SLT 相比，序贯性激光消融术后供胎 FHR 更稳定，提示供胎血液动力学改善。
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