双胎妊娠绒毛膜性对胎儿宫内死亡风险和时间的影响。

Impact of chorionicity on risk and timing of intrauterine fetal demise in twin pregnancies.

机构信息

Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA.

出版信息

Am J Obstet Gynecol. 2012 Sep;207(3):190.e1-6. doi: 10.1016/j.ajog.2012.07.031. Epub 2012 Jul 27.

DOI:10.1016/j.ajog.2012.07.031

PMID:22939722

Abstract

OBJECTIVE

We sought to estimate the association between chorionicity and intrauterine fetal demise (IUFD) of one or both fetuses in twin pregnancies.

STUDY DESIGN

In a retrospective cohort of twins undergoing anatomic survey, risk of IUFD in monochorionic and dichorionic twins was compared. The primary outcome was IUFD of one or both fetuses; secondary outcomes included nonanomalous fetal deaths.

RESULTS

Of 2161 twin pregnancies meeting inclusion criteria, 86 had at least 1 IUFD and 32 experienced a double fetal loss. Monochorionic pregnancies had an increased risk of a single demise (adjusted odds ratio, 1.69; 95% confidence interval, 1.04-2.75) and a double demise (adjusted odds ratio, 2.11; 95% confidence interval, 1.02-4.37). Of all double demises, 70% occurred <24 weeks.

CONCLUSION

Monochorionic twins carry an increased risk of fetal death compared to dichorionic twins. Double demise occurs primarily <24 weeks, regardless of chorionicity.

摘要

目的

我们旨在评估双胞胎妊娠中胎盘的绒毛膜性与一胎或两胎胎儿宫内死亡（IUFD）之间的关联。

研究设计

在对双胞胎进行解剖学检查的回顾性队列中，比较了单绒毛膜和双绒毛膜双胞胎中 IUFD 的风险。主要结局是一胎或两胎胎儿的 IUFD；次要结局包括非畸形胎儿死亡。

结果

在符合纳入标准的 2161 例双胞胎妊娠中，86 例至少有 1 例 IUFD，32 例经历了双胎胎儿死亡。单绒毛膜妊娠一胎死亡的风险增加（调整后的优势比，1.69；95%置信区间，1.04-2.75），双胎死亡的风险也增加（调整后的优势比，2.11；95%置信区间，1.02-4.37）。所有双胎死亡中，70%发生在<24 周。