胎儿镜激光手术后双胎输血综合征中的新生儿持续性肺动脉高压
Persistent pulmonary hypertension of the newborn in twin-twin transfusion syndrome following fetoscopic laser surgery.
作者信息
Takahashi Hironori, Takahashi Shigehiro, Tsukamoto Keiko, Ito Yushi, Nakamura Tomoo, Hayashi Satoshi, Sago Haruhiko
机构信息
Department of Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan.
出版信息
J Matern Fetal Neonatal Med. 2012 May;25(5):543-5. doi: 10.3109/14767058.2011.594469. Epub 2011 Aug 10.
OBJECTIVE
We investigated persistent pulmonary hypertension of the newborn (PPHN) among monochorionic-diamniotic (MD) twins.
METHODS
A retrospective cohort study examined MD twins from 195 deliveries and 373 live-born neonates at our center.
RESULTS
PPHN occurred in three cases (3/373: 0.8%), all of which were recipients of twin-twin transfusion syndrome (TTTS), after fetoscopic laser surgery (FLS) (3/117: 2.6%). Although the clinical course of the three cases differed, all cardiothoracic area ratios exceeded 40%, and other cardiac parameters also worsened after FLS.
CONCLUSIONS
The occurrence of PPHN in TTTS recipients should be noted, particularly when fetal cardiac function declines following FLS.
目的
我们调查了单绒毛膜双羊膜囊（MD）双胎中的新生儿持续性肺动脉高压（PPHN）情况。
方法
一项回顾性队列研究对本中心195例分娩的MD双胎及373例活产新生儿进行了检查。
结果
PPHN发生于3例（3/373：0.8%），所有病例均为双胎输血综合征（TTTS）受血儿，且均在胎儿镜激光手术（FLS）后发生（3/117：2.6%）。尽管这3例的临床过程有所不同，但所有心胸面积比均超过40%，且FLS后其他心脏参数也恶化。
结论
应注意TTTS受血儿中PPHN的发生，尤其是在FLS后胎儿心功能下降时。
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