Maternal-Fetal Medicine Department, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, Hospital Clínic, University of Barcelona, Barcelona, Spain.
Fetal Diagn Ther. 2012;32(3):145-55. doi: 10.1159/000342751. Epub 2012 Sep 24.
Monochorionic (MC) twins represent a significant proportion of perinatal morbidity and mortality. Overall, 1 of 3 MC twin pregnancies will develop complications in relation to the MC placenta and the presence of interfetal placental anastomoses. From a clinical standpoint, these complications can be grouped into four main types of clinical problems: chronic transfusion, acute transfusion, growth discordance, and discordant malformation. Differential diagnosis of MC twin complications is still challenging due to frequent overlap of their clinical signs and the complex relationships between them. Clinical experience demonstrates that most instances of wrong management derive from failure to comply with a basic set of rules for diagnosis and management. In this review, we propose a simplified approach to the understanding of MC twin pregnancy, its potential complications, and the key concepts allowing adequate differential diagnosis and targeted management.
单绒毛膜（MC）双胞胎在围产期发病率和死亡率中占很大比例。总体而言，3 例 MC 双胞胎妊娠中就有 1 例会因 MC 胎盘和胎间胎盘吻合的存在而出现并发症。从临床角度来看，这些并发症可分为四大类临床问题：慢性输血、急性输血、生长不一致和不一致的畸形。由于其临床体征经常重叠，且彼此之间关系复杂，MC 双胞胎并发症的鉴别诊断仍然具有挑战性。临床经验表明，大多数管理错误都源于未能遵守一套用于诊断和管理的基本规则。在这篇综述中，我们提出了一种简化方法来理解 MC 双胞胎妊娠及其潜在并发症，以及允许充分鉴别诊断和针对性管理的关键概念。
