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中期双胎妊娠人工流产术后的胎儿病理学研究。

Fetopathological investigations after induced abortions performed in mid-term gemini pregnancies.

机构信息

1st Department of Obstetrics and Gynaecology, Semmelweis University Medical School, 1088 Budapest, Baross utca 27, Hungary.

出版信息

Pathol Res Pract. 2011 Jul 15;207(7):443-7. doi: 10.1016/j.prp.2011.04.003. Epub 2011 May 19.

Abstract

Multiple pregnancies present a special obstetric condition whose importance has increased due to the spread of assisted reproductive techniques. We have processed the fetopathological data of 43 abortions induced in mid-term gemini pregnancies, owing to malformations affecting one or both fetuses. 67.4% of the gemini pregnancies were conceived naturally and 32.6% by assisted reproduction techniques. The most commonly occurring malformations affected the fetuses' cardiovascular and central nervous systems. Positive histories could be detected in 23% of the cases. The male-to-female ratio was found to be 1.14. In the majority of the cases with central nervous system malformation, fetus "A" was affected (85.7%). In 29.4% of the cases, monochorionic placentation was established. Ultrasonography and fetopatological findings yielded perfectly matching results in 78.9% of the cases. The incidence of fetal malformations is probably not higher among fetuses conceived by assisted reproduction techniques compared to the ones conceived naturally. Fetal central nervous system malformations usually affect fetus "A". Based on the results of the fetopathological examinations, ultrasonography is a reliable method in the diagnostics of malformations affecting twin fetuses. Fetal echocardiography is indicated simply because of the pregnancy being a multiple one.

摘要

多胎妊娠是一种特殊的产科情况,由于辅助生殖技术的普及,其重要性有所增加。我们处理了 43 例中期双胎妊娠因胎儿畸形而引产的胎儿病理数据,这些畸形影响了一个或两个胎儿。67.4%的双胎妊娠是自然受孕,32.6%是通过辅助生殖技术受孕。最常见的畸形影响胎儿的心血管和中枢神经系统。在 23%的病例中可以检测到阳性病史。男性与女性的比例为 1.14。在大多数中枢神经系统畸形的病例中,胎儿“A”受到影响(85.7%)。在 29.4%的病例中,确定为单绒毛膜胎盘。超声检查和胎儿病理学检查结果在 78.9%的病例中完全吻合。与自然受孕的胎儿相比,通过辅助生殖技术受孕的胎儿的胎儿畸形发生率可能并没有更高。胎儿中枢神经系统畸形通常影响胎儿“A”。根据胎儿病理学检查结果,超声检查是诊断双胎胎儿畸形的可靠方法。仅仅因为妊娠是多胎妊娠,就需要进行胎儿心脏超声检查。

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