López-Velasco Nuria, Sotillo-Mallo Laura, Martínez-Montoro Begoña, Fernández-Miranda María de la Calle
Servicio de Obstetricia, Hospital Universitario La Paz, Madrid, España.
Ginecol Obstet Mex. 2013 Mar;81(3):158-62.
The association between Patau's syndrome and multiple pregnancy is extremely rare. This paper reports three cases with different obstetric treatment. CASE 1: Dichorionic diamniotic twin pregnancy with a fetus affected by trisomy 13 diagnosed at 16 weeks of gestation. The pregnancy was managed conservatively resulting in the delivery of twins at 38 weeks. The structurally normal twin was male survived without sequelae, but the female fetus with trisomy 13 died shortly after delivery. CASE 2: Dichorionic diamniotic twin pregnancy. At 14 weeks of pregnancy, one of the fetus affected by trisomy 13 showed an early intrauterine growth restriction and a cystic hygroma. At 16 weeks of pregnancy the abnormal twin died spontaneously. Avaginal delivery occurred at 38 weeks being born a healthy male. CASE 3: Dichorionic diamniotic twin pregnancy. The trisomy 13 fetus had been diagnosed at 17 weeks of pregnancy and showed a cardiopathy. At 32 weeks of gestation a selective fetal reduction was performed. Vaginal delivery occurred at 35 weeks and a healthy newborn was born.
Patau's syndrome has an unfortunate fetal and neonatal outcome. It is important an early diagnosis to establish the best strategy to minimize the risk of the healthy twin.
帕陶氏综合征与多胎妊娠之间的关联极为罕见。本文报告三例采用不同产科治疗方法的病例。病例1:双绒毛膜双羊膜囊双胎妊娠,孕16周时诊断出一胎患有13三体综合征。该妊娠采取保守治疗,孕38周时分娩出双胞胎。结构正常的双胞胎为男性,存活且无后遗症,但患有13三体综合征的女胎在出生后不久死亡。病例2:双绒毛膜双羊膜囊双胎妊娠。孕14周时,受13三体综合征影响的一胎出现早期宫内生长受限和囊状水瘤。孕16周时,异常胎儿自发死亡。孕38周时经阴道分娩出一名健康男婴。病例3:双绒毛膜双羊膜囊双胎妊娠。孕17周时诊断出13三体胎儿,且该胎儿患有心脏病。孕32周时实施了选择性减胎术。孕35周时经阴道分娩,出生一名健康新生儿。
帕陶氏综合征会导致不良的胎儿和新生儿结局。早期诊断对于制定最佳策略以降低健康胎儿的风险至关重要。