National Referral Centre for the Management of Complicated Monochorionic Pregnancies, Department of Obstetrics and Fetal Medicine, Paris Descartes University, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants-Malades, 75015 Paris, France.
Prenat Diagn. 2011 Jul;31(7):637-46. doi: 10.1002/pd.2803. Epub 2011 Jun 9.
Monochorionic twins are subjected to specific complications which originate in either imbalance or abnormality of the single placenta serving two twins including twin-to-twin transfusion syndrome. The diagnosis is well established in overt clinical forms with the association of polyuric polyhydramnios and oliguric oligohydramnios. The best treatment of cases presenting before 26 weeks of gestion is fetoscopic laser ablation of the intertwin anastomoses on the chorionic plate. Although subjected to subtle variations, the core technique follows robust guidelines which could help understanding and acquiring the required skills and experience to perform this procedure. However appropriate and tailored hands-on training and appropriate perinatal set-up are critical not only for surgical management but also for the follow-up and management of related complications.
单绒毛膜性双胎易发生特有的并发症，这些并发症源于为两个胎儿服务的单一胎盘的失衡或异常，包括双胎输血综合征。在显性临床形式中，多尿性羊水过多和少尿性羊水过少的并存可明确诊断。对于 26 周前出现的病例，最好的治疗方法是在胎盘绒毛膜板上进行胎儿镜下双胎间吻合管激光消融术。尽管存在细微差异，但核心技术遵循稳健的指南，这有助于理解和获得执行该手术所需的技能和经验。然而，适当的、量身定制的实践培训和适当的围产期设置不仅对手术管理至关重要，对相关并发症的随访和管理也至关重要。
