双胎输血综合征经所罗门激光治疗后胎盘早剥风险增加。

Increased risk of placental abruption after solomon laser treatment of twin-twin transfusion syndrome.

作者信息

Lanna M M, Faiola S, Consonni D, Rustico M A

机构信息

Fetal Therapy Unit " U.Nicolini", Vittore Buzzi Children's Hospital, Università degli Studi di Milano, Milan, Italy.

出版信息

Placenta. 2017 May;53:54-56. doi: 10.1016/j.placenta.2017.03.018. Epub 2017 Mar 30.

DOI:10.1016/j.placenta.2017.03.018

PMID:28487021

Abstract

To evaluate the relative risk of placental abruption in monochorionic (MC) twin pregnancies complicated with twin-to-twin transfusion syndrome (TTTS) and treated with endoscopic laser coagulation of placental vessels (ELCPV). A retrospective analysis from January 2004 and December 2015 of 373 TTTS pregnancies, treated with selective ELCPV until January 2012 (287 cases), after which the Solomon technique was introduced (86 cases), compared with 243 normal MC pregnancies. A significant improvement in perinatal survival was observed after the introduction of the Solomon technique when compared to the selective procedure (77% vs 54%, p < 0.001). The rate of placental abruption was 1% (3/243) in normal MC pregnancies, 6% (21/373) in TTTS group, increased with Solomon technique (12/86, 14%, vs 9/287, 3%, p < 0.001). MC twin pregnancies treated with laser coagulation of placental vascular anastomoses could be at increased risk of placental abruption, especially when the Solomon technique is used.

摘要

评估单绒毛膜（MC）双胎妊娠合并双胎输血综合征（TTTS）并接受胎盘血管内镜激光凝固术（ELCPV）治疗时胎盘早剥的相对风险。对2004年1月至2015年12月期间373例TTTS妊娠进行回顾性分析，2012年1月前采用选择性ELCPV治疗（287例），之后引入所罗门技术（86例），并与243例正常MC妊娠进行比较。与选择性手术相比，引入所罗门技术后围产期生存率有显著提高（77%对54%，p<0.001）。正常MC妊娠中胎盘早剥发生率为1%（3/243），TTTS组为6%（21/373），采用所罗门技术时增加（12/86，14%，对9/287，3%，p<0.001）。接受胎盘血管吻合术激光凝固治疗的MC双胎妊娠可能有更高的胎盘早剥风险，尤其是采用所罗门技术时。