Bahlmann F
Frauenklinik, Perinatalzentrum Level I, Frankfurt am Main, Germany. f.bahlmann@buergerhospital-ff m.de
Z Geburtshilfe Neonatol. 2009 Dec;213(6):234-7. doi: 10.1055/s-0029-1241808.
Monochorionic twin pregnancies have an increased risk of intrauterine and postnatal complications because of the present placental vascular anastomoses. The main problems are the development of twin-to-twin transfusion syndrome,selective intrauterine growth restriction, monoamniotic twins and single intrauterine death on the one hand and congenital abnormalities like twin reversed-arterial perfusion and conjoined twins on the other hand. Fetoscopic laser therapy with selective coagulation of placental intertwin anastomoses is the best option in the treatment of twin-to-twin transfusion syndrome. The risk of preterm delivery, cerebral injury and abnormalities of long-term neurodevelopmental outcome are increased. Perinatal management of monochorionic twin pregnancies should be performed in specialized tertiar centers.
由于存在胎盘血管吻合，单绒毛膜双胎妊娠发生宫内和产后并发症的风险增加。主要问题一方面是双胎输血综合征、选择性胎儿生长受限、单羊膜囊双胎和单胎宫内死亡的发生，另一方面是诸如双胎反向动脉灌注序列征和联体双胎等先天性异常。胎儿镜下激光治疗并选择性凝固胎盘双胎间吻合血管是治疗双胎输血综合征的最佳选择。早产、脑损伤和长期神经发育结局异常的风险增加。单绒毛膜双胎妊娠的围产期管理应在专业的三级中心进行。
