Amato M, Hüppi P, Schneider H
Department of Obstetrics and Gynecology, University of Berne, Switzerland.
Eur J Obstet Gynecol Reprod Biol. 1990 Jan-Feb;34(1-2):73-8. doi: 10.1016/0028-2243(90)90009-p.
A marked intrapair discordance in placentas and in many body and organ measurements are risk factors influencing perinatal mortality and morbidity in twins. Asphyxia is the single most important perinatal cause of neurologic morbidity in newborn infants. The higher hypoxic risk for the second twin arises, however, from conclusions based on studies that did not consider the new diagnostic possibility of using blood measurements of the brain-type isoenzyme of creatine kinase (CK-BB) as a marker of perinatal asphyxia. CK-BB levels were measured in cord blood of 60 preterm infants (mean birth weight 1670 +/- 390 g, and mean gestational age 33 +/- 1.9 weeks) born of twin gestation in the last 3 years. The mean CK-BB values were 48 +/- 40 U/l versus 29 +/- 31 U/l (p less than 0.5). Skilful antepartum and perinatal care are the keys for optimal management of both babies, as demonstrated by similar CK-BB values obtained in their cord-blood specimens after birth.
胎盘以及许多身体和器官测量值中显著的双胎内不一致是影响双胎围产期死亡率和发病率的危险因素。窒息是新生儿神经疾病最重要的单一围产期病因。然而，第二胎较高的缺氧风险源于一些研究得出的结论，这些研究没有考虑到将肌酸激酶脑型同工酶（CK-BB）的血液测量作为围产期窒息标志物这一新的诊断可能性。对过去3年双胎妊娠出生的60例早产儿（平均出生体重1670±390g，平均胎龄33±1.9周）的脐带血进行了CK-BB水平测定。CK-BB的平均值为48±40U/l，而另一组为29±31U/l（p<0.5）。出生后脐带血标本中获得的相似CK-BB值表明，熟练的产前和围产期护理是两个婴儿最佳管理的关键。
