Lopriore Enrico, Holtkamp Nanneke, Sueters Marieke, Middeldorp Johanna M, Walther Frans J, Oepkes Dick
Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
J Obstet Gynaecol Res. 2014 Jan;40(1):18-24. doi: 10.1111/jog.12114. Epub 2013 Jul 22.
The aim of this study was to examine the incidence, placental characteristics and outcome in acute peripartum twin-twin transfusion syndrome (TTTS).
All consecutive cases of monochorionic (MC) twins admitted to our center were included in the study. We excluded cases with chronic TTTS or twin anemia polycythemia sequence. Acute peripartum TTTS was defined when the inter-twin hemoglobin difference at birth was >8 g/dL.
A total of 241 MC twin pregnancies were included in the study. Acute peripartum TTTS was detected in six cases (2.5%, 6/241). Vaginal delivery occurred more often in the acute peripartum TTTS group compared to the control group of uncomplicated MC pregnancies, 100% (6/6) versus 57% (135/235) (P = 0.002), respectively. Acute anemia was detected only in firstborn twins. Placental angioarchitecture in acute peripartum TTTS was similar to the placentas in the control group.
The incidence of acute peripartum TTTS is low (2.5%). Birth order and mode of delivery appear to be associated with increased risk of acute peripartum TTTS.
本研究旨在探讨急性围产期双胎输血综合征（TTTS）的发病率、胎盘特征及结局。
本研究纳入了所有连续入住我们中心的单绒毛膜（MC）双胎病例。我们排除了慢性TTTS或双胎贫血红细胞增多序列的病例。当出生时双胎间血红蛋白差异>8 g/dL时，定义为急性围产期TTTS。
本研究共纳入241例MC双胎妊娠。6例（2.5%，6/241）检测到急性围产期TTTS。与无并发症的MC妊娠对照组相比，急性围产期TTTS组阴道分娩更为常见，分别为100%（6/6）和57%（135/235）（P = 0.002）。仅在第一出生的双胎中检测到急性贫血。急性围产期TTTS的胎盘血管结构与对照组的胎盘相似。
急性围产期TTTS的发病率较低（2.5%）。出生顺序和分娩方式似乎与急性围产期TTTS风险增加有关。
