Division of Maternal Fetal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Kagawa National Children's Hospital, Zentsuji 2603, Zentsuji, Kagawa 765-8501, Japan.
Arch Gynecol Obstet. 2011 Jun;283(6):1239-43. doi: 10.1007/s00404-010-1549-3. Epub 2010 Jun 12.
To investigate the factors affecting the perinatal outcome in monochorionic diamniotic (MD) twins.
We conducted a retrospective study of MD twins treated in our hospital between April 1, 2006 and February 28, 2010. The neonatal outcomes of MD twins conceived by assisted reproductive technology or ovulation induction were compared to the outcomes of those conceived naturally.
In MD twins with twin-to-twin transfusion syndrome (TTTS), fetoscopic laser photocoagulation (FLP) resulted in the survival of at least one twin. In naturally conceived MD twins with two live births, we found that there was a higher discordance rate and the incidence of intrauterine growth retardation was higher in twins born to nulliparous women than multiparous women.
Further FLP treatment can be performed on twins with TTTS so that prognosis may be improved. Since the risk of discordant growth is significantly greater in twins of nulliparous women, they should be monitored more carefully than multiparous women.
探讨影响单绒毛膜双羊膜囊（MD）双胎围生结局的因素。
我们对 2006 年 4 月 1 日至 2010 年 2 月 28 日在我院治疗的 MD 双胎进行了回顾性研究。比较了辅助生殖技术或排卵诱导受孕的 MD 双胎与自然受孕的 MD 双胎的新生儿结局。
在患有双胎输血综合征（TTTS）的 MD 双胎中，胎儿镜激光凝固术（FLP）使至少有一胎存活。在自然受孕的 MD 双胎中，我们发现，在经产妇所分娩的双胎中，两胎的出生体重差异率更高，宫内生长受限的发生率也更高。
对 TTTS 双胎可进一步行 FLP 治疗，以改善预后。由于初产妇的双胎生长不一致的风险显著更大，因此应比经产妇更密切地监测。
