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经阴道镜激光光凝术治疗双胎输血综合征:来自香港的局部经验。

Fetoscopic laser photocoagulation in the management of twin-twin transfusion syndrome: local experience from Hong Kong.

机构信息

Prenatal Diagnostic Centre, Guangzhou Obstetrics and Neonatal Hospital, Guangzhou, Guangdong, PR China.

出版信息

Hong Kong Med J. 2010 Aug;16(4):275-81.

PMID:20683070
Abstract

OBJECTIVE

To review the perinatal outcome of monochorionic twin pregnancies treated by fetoscopic laser coagulation for twin-twin transfusion syndrome.

DESIGN

Retrospective study.

SETTING

A university teaching hospital in Hong Kong.

PATIENTS

Thirty consecutive cases of fetoscopic laser coagulation of placental anastomoses for twin-twin transfusion syndrome performed in a single centre.

MAIN OUTCOME MEASURES

Operative complications and perinatal survival rates.

RESULTS

The median gestational age at initial presentation, laser photocoagulation, and delivery were 22 (range, 16-27) weeks, 23 (18-28) weeks, and 32 (21-37) weeks, respectively. To improve the visualisation, in three cases amnio-exchange was undertaken; the procedure was abandoned in two due to poor visualisation. The overall fetal survival rate, the double infant survival rate, and survival rate for at least one twin were 72% (43/60), 60% (18/30), and 83% (25/30), respectively. The most common peri-operative complication was bleeding from the uterine wall into the amniotic cavity, which affected three (10%) patients.

CONCLUSIONS

Our results of fetoscopic laser surgery for twin-twin transfusion syndrome were similar to those in specialised centres in other countries.

摘要

目的

回顾接受胎儿镜激光凝固术治疗的双胎输血综合征的围产结局。

设计

回顾性研究。

地点

中国香港一所大学教学医院。

患者

在单一中心接受胎儿镜胎盘吻合处激光凝固术治疗的 30 例双胎输血综合征连续病例。

主要观察指标

手术并发症和围产儿存活率。

结果

首次就诊、激光凝固术和分娩的中位孕龄分别为 22(16-27)周、23(18-28)周和 32(21-37)周。为改善可视化效果,在 3 例病例中进行了羊水交换;由于可视化效果不佳,有 2 例病例放弃了该操作。总的胎儿存活率、双胎存活率和至少存活 1 个胎儿的存活率分别为 72%(43/60)、60%(18/30)和 83%(25/30)。最常见的围手术期并发症是子宫壁出血进入羊膜腔,影响了 3 例(10%)患者。

结论

我们对双胎输血综合征进行胎儿镜激光手术的结果与其他国家专门中心的结果相似。

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Prenat Diagn. 2019 Mar;39(4):251-268. doi: 10.1002/pd.5421. Epub 2019 Feb 27.
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Fetal Survival Immediate after Fetoscopic Laser Ablation in Twin to Twin Transfusion Syndrome.双胎输血综合征羊膜镜激光凝固术后即刻胎儿存活。
J Korean Med Sci. 2019 Jan 7;34(3):e20. doi: 10.3346/jkms.2019.34.e20. eCollection 2019 Jan 21.
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Model Surgical Training: Skills Acquisition in Fetoscopic Laser Photocoagulation of Monochorionic Diamniotic Twin Placenta Using Realistic Simulators.
模拟手术训练:使用逼真模拟器进行单绒毛膜双羊膜囊双胎胎盘胎儿镜激光凝固术的技能获取
J Vis Exp. 2018 Mar 21(133):57328. doi: 10.3791/57328.