Szymański Sławomir, Malinowski Witold, Ronin-Walknowska Elibieta
Kameda i Zakład Pielegniarstwa Połozniczo-Ginekologicznego PAM.
Med Wieku Rozwoj. 2010 Oct-Dec;14(4):378-83.
Twin pregnancies are regarded as high risk pregnancies. It results from the possibility of occurrence of numerous complications both like the ones in singleton pregnancies and those characteristic for multiple pregnancy only. The complication occurring exclusively in multiple pregnancies is discordant intrauterine growth of the fetuses.
a response to the question if there a relationship between the type of afterbirth and twin birth weight discordance.
Material of the research consisted of 186 afterbirths derived from successful twin pregnancies. In the study the following were taken into consideration: evaluation of placenta/placentas types (mono- or dichorionic), place of umbilical cords insertion, and differences concerning birth weight of newborns.
The birth weight discordance of less than 10% (l0) in the twins was noted in 52.7% of pregnancies (n=98), discordance of 10-20% (II degree) was observed in 30.1% (n=56), and over 20% (III degree) in 17.2% (n=32). The birth weight discordance of the third degree was observed significantly more often in dichorionic diamniotic pregnancies with fused placentas. The discordance of third degree (>20%) occurred in 38.2% of female-male pairs, in 35.7% of female-female ones and in 24.3% of male-male pairs. In case of coexistence of both normal umbilical cord insertions the birth weight discordance of third degree occurred in 17.8% of pregnancies, in case of co-occurrence of the abnormal insertion with the normal one--in 21.8% of cases, and in case of the two abnormal insertions--in 10.5%. No statistically significant differences were found.
There is a relationship between the type of afterbirth and birth weight in twins. The largest birth weight discordance between fetuses occurs in the following cases: in dichorionic pregnancies with fused placental discs, in case of co-existence of abnormal and normal umbilical cord insertions and in female-male pair of twins.
双胎妊娠被视为高危妊娠。这是因为其既可能出现与单胎妊娠相同的多种并发症，也可能出现仅双胎妊娠特有的并发症。双胎妊娠特有的并发症是胎儿宫内生长不一致。
回答胎盘类型与双胎出生体重不一致之间是否存在关联这一问题。
研究材料包括186例成功双胎妊娠后的胎盘。研究中考虑了以下因素：胎盘类型（单绒毛膜或双绒毛膜）、脐带插入位置以及新生儿出生体重差异。
双胎出生体重不一致小于10%（I度）的情况在52.7%的妊娠中出现（n = 98），10% - 20%（II度）的情况在30.1%（n = 56）的妊娠中出现，超过20%（III度）的情况在17.2%（n = 32）的妊娠中出现。在双绒毛膜双羊膜囊且胎盘融合的妊娠中，III度出生体重不一致的情况明显更常见。III度不一致（>20%）在双胎为一男一女的情况中占38.2%，在双女胎中占35.7%，在双男胎中占24.3%。若两根脐带插入均正常，III度出生体重不一致在17.8%的妊娠中出现；若一根脐带插入异常与一根正常同时存在，在21.8%的情况中出现；若两根脐带插入均异常，在10.5%的情况中出现。未发现统计学上的显著差异。
双胎的胎盘类型与出生体重之间存在关联。胎儿出生体重差异最大的情况如下：双绒毛膜且胎盘融合的妊娠、脐带插入异常与正常同时存在的情况以及双胎为一男一女的情况。
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