Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
J Perinatol. 2010 Oct;30(10):660-4. doi: 10.1038/jp.2010.19. Epub 2010 Mar 4.
To determine the incidence of fetal vessel thrombosis in monochorionic-diamniotic and dichorionic-diamniotic twin placentas, and its association with intrauterine growth retardation (IUGR), hypertensive disorders of pregnancy, twin-twin transfusion syndrome (TTTS), fetal vascular anastomoses, chorangiosis, and chorioamnionitis.
Histologic slides from 80 pairs of monochorionic and 80 pairs of dichorionic twin placentas were reviewed for evidence of fetal vessel thrombosis (≥5 adjacent avascular terminal villi with upstream intravascular fibrin thrombi). Associations with clinical and other pathologic variables were analyzed by χ(2) tests.
Thrombosis occurred in 7.5% of monochorionic and 3.1% of dichorionic twin placentas (P=0.090). It was associated with IUGR among the monochorionic twins (P=<0.0001) and with hypertensive disorders of pregnancy among the dichorionic twins (P=0.018). Vascular anastomoses, TTTS, chorangiosis, and chorioamnionitis were not associated with fetal vessel thrombosis.
Fetal vessel thrombosis was identified more frequently in monochorionic twins, but this difference was not statistically significant. It is associated with IUGR in monochorionic twins, but not with TTTS or fetal vascular anastomoses at the chorionic surface.
确定单绒毛膜-双羊膜和双绒毛膜-双羊膜双胞胎胎盘胎儿血管血栓形成的发生率，及其与宫内生长受限（IUGR）、妊娠高血压疾病、双胎输血综合征（TTTS）、胎儿血管吻合、绒毛膜血管瘤和绒毛膜羊膜炎的关系。
对 80 对单绒毛膜和 80 对双绒毛膜双胞胎胎盘的组织学切片进行了检查，以寻找胎儿血管血栓形成的证据（≥5 个相邻无血管终末绒毛，上游血管内有纤维蛋白血栓）。通过 χ(2)检验分析与临床和其他病理变量的关联。
血栓形成发生在 7.5%的单绒毛膜和 3.1%的双绒毛膜双胞胎胎盘（P=0.090）。在单绒毛膜双胞胎中，它与 IUGR 相关（P=<0.0001），而在双绒毛膜双胞胎中，它与妊娠高血压疾病相关（P=0.018）。血管吻合、TTTS、绒毛膜血管瘤和绒毛膜羊膜炎与胎儿血管血栓形成无关。
胎儿血管血栓形成在单绒毛膜双胞胎中更常见，但差异无统计学意义。它与单绒毛膜双胞胎中的 IUGR 相关，但与 TTTS 或绒毛膜表面的胎儿血管吻合无关。
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