单绒毛膜/单羊膜囊双胎中脐动脉切迹的存在。
Presence of an umbilical artery notch in monochorionic/monoamniotic twins.
作者信息
Aurioles-Garibay Alma, Hernandez-Andrade Edgar, Romero Roberto, Garcia Maynor, Qureshi Faisal, Jacques Suzanne M, Ahn Hyunyoung, Yeo Lami, Chaiworapongsa Tinnakorn, Hassan Sonia S
机构信息
Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Md., and Detroit, Mich., USA.
出版信息
Fetal Diagn Ther. 2014;36(4):305-11. doi: 10.1159/000361020. Epub 2014 Jul 22.
OBJECTIVE
To examine the association between an umbilical artery notch and fetal deterioration in monochorionic/monoamniotic (MC/MA) twins.
METHODS
Six MC/MA twin pregnancies were admitted at 24-28 weeks of gestation for close fetal surveillance until elective delivery at 32 weeks or earlier in the presence of signs of fetal deterioration. Ultrasound (US) examinations were performed twice weekly. The presence of cord entanglement, umbilical artery notch, abnormal Doppler parameters, a non-reassuring fetal heart rate pattern, or an abnormal fetal biophysical profile were evaluated.
RESULTS
Umbilical cord entanglement was observed on US in all pregnancies. The presence of an umbilical artery notch was noted in four out of six pregnancies and in two of them an umbilical artery notch was seen in both twins. The umbilical artery pulsatility index was normal in all fetuses. Doppler parameters of the middle cerebral artery and ductus venosus, fetal biophysical profile and fetal heart rate monitoring remained normal until delivery in all pregnancies. All neonates experienced morbidity related to prematurity; however, all were discharged home in good condition.
CONCLUSION
The presence of an umbilical artery notch and cord entanglement, without other signs of fetal deterioration, are not indicative of an adverse perinatal outcome.
目的
探讨单绒毛膜/单羊膜囊（MC/MA）双胎妊娠中脐动脉切迹与胎儿状况恶化之间的关联。
方法
6例MC/MA双胎妊娠于妊娠24 - 28周入院，进行密切的胎儿监测，直至出现胎儿状况恶化迹象时在32周或更早进行选择性分娩。每周进行两次超声（US）检查。评估脐带缠绕、脐动脉切迹、异常多普勒参数、胎儿心率图形异常或胎儿生物物理评分异常的情况。
结果
所有妊娠超声检查均发现脐带缠绕。6例妊娠中有4例发现脐动脉切迹，其中2例两个胎儿均可见脐动脉切迹。所有胎儿的脐动脉搏动指数均正常。所有妊娠直至分娩时，大脑中动脉和静脉导管的多普勒参数、胎儿生物物理评分及胎儿心率监测均保持正常。所有新生儿均出现与早产相关的疾病；然而，所有新生儿均状况良好出院。
结论
存在脐动脉切迹和脐带缠绕，若无其他胎儿状况恶化迹象，则不提示围产期不良结局。
Zotero 插件