Shah D M, Chaffin D
Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, Nashville, TN.
Am J Obstet Gynecol. 1989 Nov;161(5):1111-3. doi: 10.1016/0002-9378(89)90644-3.
We retrospectively studied 48 pairs of twin gestations delivered between 24 and 28 weeks' gestation from 1975 to 1986 at Vanderbilt University Medical Center. The incidence of fetofetal transfusion syndrome was 20%, more than double the incidence previously reported in large series of twin deliveries that encompassed a wider gestational age range. The overall mortality was 55%, and mortality for the fetofetal transfusion group was 70%, whereas a subset of the fetofetal transfusion group, those without weight discordancy, had a mortality rate of 75%. Our findings suggest that traditional reliance on ultrasonographic criteria for diagnosis of fetofetal transfusion will not detect 40% of such cases. The poor outcome data suggest a need for innovative approaches to diagnosis and treatment.
我们回顾性研究了1975年至1986年间在范德比尔特大学医学中心分娩的48对孕24至28周的双胎妊娠。胎儿-胎儿输血综合征的发生率为20%，比之前在涵盖更广泛孕周范围的大型双胎分娩系列报道的发生率高出一倍多。总体死亡率为55%，胎儿-胎儿输血组的死亡率为70%，而胎儿-胎儿输血组中体重无差异的一个亚组的死亡率为75%。我们的研究结果表明，传统上依靠超声标准诊断胎儿-胎儿输血将无法检测出40%的此类病例。不良的结局数据表明需要创新的诊断和治疗方法。
