Takahashi Yuichiro, Iwagaki Shigenori, Chiaki Rika, Asai Kazuhiko, Matsui Masako, Kawabata Ichiro
Department of Fetal-Maternal Medicine, Nagara Medical Center, 1300-7, Nagara, Gifu, 502-87558, Japan.
J Med Ultrason (2001). 2018 Jan;45(1):185-187. doi: 10.1007/s10396-017-0792-7. Epub 2017 May 9.
We performed a dual-gate Doppler examination for a twin reversed arterial perfusion (TRAP) sequence in a monochorionic-triamniotic triplet pregnancy at 16 weeks of gestation and were able to identify the pump twin by arterial pulse rate synchronicity. We performed radiofrequency ablation to coagulate blood flow in the acardius at 16 weeks of gestation without any postoperative complication. At 29 weeks of gestation, we performed a cesarean section due to preterm rupture of the membranes and the patient delivered 1167/1237-g female neonates and a macerated acardius. Examination of the placenta revealed two thickened vessels from the pump twin to the acardius, which had been prenatally identified by dual-gate Doppler. This new technology launches the new field of noninvasive fetal identification for triplet TRAP sequence.
我们对一例单绒毛膜三羊膜囊三胎妊娠孕16周时的双胎反向动脉灌注序列进行了双门控多普勒检查，并通过动脉搏动同步性识别出了泵血胎儿。我们在孕16周时对无心胎儿进行了射频消融以凝固血流，术后无任何并发症。孕29周时，因胎膜早破进行了剖宫产，患者娩出了体重分别为1167/1237克的女婴和一个浸软的无心胎儿。胎盘检查发现有两条增粗的血管从泵血胎儿延伸至无心胎儿，这两条血管在产前通过双门控多普勒已被识别。这项新技术开创了三胎双胎反向动脉灌注序列无创胎儿识别的新领域。
