窦性心率模式作为一例单绒毛膜-双羊膜性双胎妊娠中胎儿-母体大量失血的表现：一例病例报告。

Sinusoidal heart rate patterns as a manifestation of massive fetomaternal hemorrhage in a monochorionic-diamniotic twin pregnancy: a case report.

机构信息

Division of Obstetrics, Department of Perinatology, National Center for Child Health and Development, Setagaya, Tokyo, Japan.

出版信息

Fetal Diagn Ther. 2010;27(3):168-70. doi: 10.1159/000283513. Epub 2010 Feb 10.

DOI:10.1159/000283513

PMID:20145386

Abstract

OBJECTIVE

A case of fetomaternal hemorrhage (FMH) in monochorionic twins is reported.

METHOD

Case report.

RESULT

The patient felt a decrease in fetal movements at 32 gestational weeks. Cardiotocography showed sinusoidal heart rate patterns in both fetuses. The fetal hemoglobin level in maternal blood was 6.6% (normal 0.0-1.0%). Since the patient was diagnosed with massive FMH, cesarean section was performed and both babies delivered to receive neonatal treatment. Severe anemia was apparent in both infants, based on red blood cell count, hemoglobin concentration, and hematocrit of 86 x 10 and 85 x 10(4)/mm(3) (normal 376-456 x 10(4)/mm(3)), 3.1 g/dl each (normal 10.9-13.5 g/dl), and 10.7 and 10.4% (normal 32.2-41.2%), respectively. Severe anemia may develop in both fetuses following massive FMH in monochorionic twins. As such, if abnormal circulation is detected in 1 monochorionic twin, the other fetus will also require special attention.

摘要

目的

报告一例单绒毛膜双胞胎的胎母输血（FMH）病例。

方法

病例报告。

结果

患者在妊娠 32 周时感到胎动减少。胎心监护显示两个胎儿均呈窦性心率模式。母亲血液中的胎儿血红蛋白水平为 6.6%（正常值 0.0-1.0%）。由于患者被诊断为大量 FMH，因此进行了剖宫产，两个婴儿均分娩以接受新生儿治疗。根据红细胞计数、血红蛋白浓度和血细胞比容，两个婴儿均明显贫血，分别为 86 x 10 和 85 x 10(4)/mm(3)（正常值 376-456 x 10(4)/mm(3)）、3.1 g/dl（正常值 10.9-13.5 g/dl）和 10.7%和 10.4%（正常值 32.2-41.2%）。大量 FMH 后，两个胎儿均可能发生严重贫血。因此，如果在一个单绒毛膜双胞胎中检测到异常循环，另一个胎儿也需要特别关注。