Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA 19104, USA.
Ultrasound Obstet Gynecol. 2010 Jul;36(1):48-51. doi: 10.1002/uog.7612.
To determine pregnancy outcomes of patients who present with Stage I twin-to-twin transfusion syndrome (TTTS).
This was a retrospective review of all patients with TTTS referred to our institution between January 2005 and December 2006. Quintero criteria were used for staging. Laser ablation was not offered to patients with Stage I disease.
A total of 155 twin pregnancies were evaluated for TTTS during this period. Forty-two met the criteria for Stage I and were included in the analysis. The overall survival to discharge was 82%. The mean gestational age at the time of consultation was 20.9 +/- 0.4 weeks. A total of 23 cases (54.8%) underwent amnioreduction. Progression of TTTS requiring invasive therapy occurred in four cases. The mean gestational age at delivery was 32.5 +/- 0.62 weeks. When divided according to use of amnioreduction, there were no statistically significant differences between the groups for gestational age at delivery or for birth weight. Those Stage I cases with a CHOP cardiovascular score of 5 or higher delivered almost 3 weeks earlier than the remainder of the cohort.
Progression of TTTS beyond Stage I occurred in only 9.5% of the cohort. Mean gestational age at delivery and survival to discharge did not differ between Stage I patients and those treated with placental laser ablation for more advanced stages of TTTS.
确定出现一期双胎输血综合征（TTTS）患者的妊娠结局。
这是对 2005 年 1 月至 2006 年 12 月期间我院收治的所有 TTTS 患者进行的回顾性分析。采用 Quintero 标准进行分期。一期疾病患者不提供激光消融治疗。
在此期间，共有 155 例双胎妊娠被评估为 TTTS。42 例符合一期标准，纳入分析。总出院存活率为 82%。咨询时的平均孕龄为 20.9 +/- 0.4 周。共 23 例（54.8%）进行了羊水减量术。4 例发生需要侵入性治疗的 TTTS 进展。平均分娩孕周为 32.5 +/- 0.62 周。根据羊水减量术的使用情况进行分组，分娩孕周和出生体重在两组之间无统计学差异。CHOP 心血管评分在 5 分或更高的一期病例的分娩时间比其余队列提前了近 3 周。
仅 9.5%的患者 TTTS 进展至一期以上。一期患者的分娩孕周和出院存活率与接受更高级别 TTTS 胎盘激光消融治疗的患者无差异。
