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双胎妊娠的特殊形式——无心双胎/双胎反向动脉灌注序列征

Special forms in twin pregnancy - ACARDIAC TWIN/ Twin reversed arterial perfusion (TRAP) sequence.

作者信息

Anca F A, Negru A, Mihart A E, Grigoriu C, Bohîlțea R E, Șerban A

机构信息

Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; Obstetrics and Gynecology Department, University Emergency Hospital Bucharest, Romania.

Obstetrics and Gynecology Department, University Emergency Hospital Bucharest, Romania.

出版信息

J Med Life. 2015 Oct-Dec;8(4):517-22.

PMID:26664482
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4656964/
Abstract

UNLABELLED

Twin pregnancy generally represents a high-risk pregnancy, but monozygous twin pregnancy is a real challenge for the obstetrician due to the serious complications that may occur during its evolution. A very rare, severe complication of monozygous twin pregnancy, which we recently dealt with in the Obstetrics and Gynecology Department of the University Emergency Hospital Bucharest, was a monochorionic monoamniotic twin pregnancy with acardiac twin (TRAP). One of the fetuses (acardiac twin) presented a rudimentary unfunctional heart or even no heart at all, underdeveloped inferior part of the body and head, being transfused by the other fetus with a normal heart (pumping twin) by one superficial arterio-arterial anastomosis through which blood pumped backwards. The understanding of these cases is mandatory in order to offer maximum survival and heath chances to the viable fetus.

ABBREVIATIONS

RFA = radiofrequency ablation, TRAP = reversed arterial perfusion.

摘要

未标注

双胎妊娠通常属于高危妊娠，但单卵双胎妊娠对产科医生来说是一项真正的挑战，因为在其发展过程中可能会出现严重并发症。我们最近在布加勒斯特大学急诊医院妇产科处理了一例非常罕见且严重的单卵双胎妊娠并发症，即单绒毛膜单羊膜囊双胎妊娠合并无心畸胎（TRAP）。其中一个胎儿（无心畸胎）心脏发育不全或根本没有心脏，身体和头部下部发育不良，通过一个浅表的动脉 - 动脉吻合支由另一个心脏正常的胎儿（供血儿）供血，血液通过该吻合支倒流。为了给存活胎儿提供最大的生存和健康机会，了解这些病例是必不可少的。

缩写

RFA = 射频消融，TRAP = 反向动脉灌注

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d11/4656964/7fd988b4f1ab/JMedLife-08-517-g0017.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d11/4656964/7fd988b4f1ab/JMedLife-08-517-g0017.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d11/4656964/76ee2c4374b4/JMedLife-08-517-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d11/4656964/b01d1536c1d5/JMedLife-08-517-g002.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d11/4656964/630351595865/JMedLife-08-517-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d11/4656964/2c7ac6748994/JMedLife-08-517-g009.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d11/4656964/b465e8eb3da9/JMedLife-08-517-g0011.jpg
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本文引用的文献

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Intrafetal laser treatment for twin reversed arterial perfusion sequence: cohort study and meta-analysis.胎儿内激光治疗双胎反向动脉灌注序列：队列研究和荟萃分析。
Ultrasound Obstet Gynecol. 2013 Jul;42(1):6-14. doi: 10.1002/uog.12495.
2
Detection of twin reversed arterial perfusion sequence at the time of first-trimester screening: the added value of 3-dimensional volume and color Doppler sonography.孕早期筛查时双胎反向动脉灌注序列的检测：三维容积和彩色多普勒超声检查的附加价值
J Ultrasound Med. 2008 Jul;27(7):1105-9. doi: 10.7863/jum.2008.27.7.1105.
3
Surgical management of twin reversed arterial perfusion sequence.
双胎反向动脉灌注序列征的外科治疗
Am J Obstet Gynecol. 2006 Apr;194(4):982-91. doi: 10.1016/j.ajog.2005.10.195.
4
Tailored management of twin reversed arterial perfusion (TRAP) sequence.双胎反向动脉灌注序列征（TRAP序列）的个体化管理
Ultrasound Obstet Gynecol. 2004 May;23(5):451-5. doi: 10.1002/uog.1040.
5
Utility of Doppler velocimetry in predicting outcome in twin reversed-arterial perfusion sequence.多普勒测速法在预测双胎反向动脉灌注序列结局中的应用
Am J Obstet Gynecol. 2001 Jul;185(1):135-9. doi: 10.1067/mob.2001.113906.