Barth R A, Filly R A, Goldberg J D, Moore P, Silverman N H
Department of Radiology, University of Vermont, Medical Center Hospital of Vermont, Burlington 05401.
Radiology. 1990 Oct;177(1):201-7. doi: 10.1148/radiology.177.1.2204966.
Prenatal diagnosis of conjoined twins is difficult and was rarely accomplished prior to the advent of sonography. Early prenatal diagnosis and assessment for shared vital organs are desirable for optimal obstetrical counseling and management. The authors retrospectively reviewed prenatal findings in 14 cases of conjoined twins. Thoracoomphalopagus was the most common type of conjoining, occurring in five cases (36%). Prenatal sonography showed shared hearts in nine (64%) cases, indicating severe conjoining and negligible chance for postnatal correction. Two sets of omphalopagus conjoined twins had separate hearts; however, severe congenital heart disease was present. Early prenatal diagnosis and assessment of the degree of conjoining provided couples with the option for pregnancy termination via vaginal delivery. In this series, nine patients elected pregnancy termination prior to 24 weeks and delivered vaginally. Transvaginal ultrasound significantly improved the delineation of conjunction in two patients, and computed tomography permitted the diagnosis to be confirmed in two patients.
联体双胎的产前诊断较为困难，在超声检查出现之前很少能够实现。早期进行产前诊断并评估共享的重要器官，对于获得最佳的产科咨询和管理很有必要。作者回顾性分析了14例联体双胎的产前检查结果。胸腹联体是最常见的联体类型，有5例（36%）。产前超声检查显示9例（64%）存在心脏共用，提示联体严重，出生后矫正的可能性微乎其微。两组脐联体双胎有各自独立的心脏；然而，存在严重的先天性心脏病。早期产前诊断和联体程度评估为夫妇提供了经阴道分娩终止妊娠的选择。在本系列中，9例患者在24周前选择终止妊娠并经阴道分娩。经阴道超声显著改善了2例患者联体情况的显示，计算机断层扫描使2例患者得以确诊。
