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单绒毛膜双胎减胎术间质激光治疗导致的先天性皮肤发育不全:保守治疗方法及结果

Aplasia cutis congenita as a result of interstitial laser therapy for fetal reduction in monochorionic twins: Conservative approach and outcome.

作者信息

Mugarab-Samedi Veronica, Lodha Abhay, ElSharkawy Adel, Al Awad Essa

机构信息

Division of Neonatology, Faculty of Pediatrics, University of Calgary, Calgary, Canada.

出版信息

Int J Surg Case Rep. 2017;41:68-70. doi: 10.1016/j.ijscr.2017.10.007. Epub 2017 Oct 10.

Abstract

Monochorionic (MC) twin pregnancies are known to carry a high risk of twin-to-twin transfusion syndrome (TTTS) that could lead to miscarriage and perinatal death. Demise of one fetus is frequently associated with co-fetal death. Fetal reduction by interstitial laser therapy is an effective procedure to prevent this outcome, but it may be associated with significant risks for both mother and fetus. Aplasia Cutis Congenita (ACC) may occur in up to 8% cases of fetal reduction by laser therapy. We report ACC in a preterm infant, a survivor of interstitial laser therapy for fetal reduction in MC pregnancy. Despite of massive skin lesions we were able to manage this case conservatively. Follow-up at 5 years of age revealed minimal scarring and no motor function limitations.

摘要

单绒毛膜(MC)双胎妊娠已知具有双胎输血综合征(TTTS)的高风险,这可能导致流产和围产期死亡。一个胎儿的死亡常常与另一胎儿死亡相关。间质激光治疗减胎术是预防这种结果的有效方法,但它可能对母亲和胎儿都有重大风险。先天性皮肤发育不全(ACC)在激光治疗减胎的病例中发生率可达8%。我们报告了一例早产儿发生ACC,该患儿是MC双胎妊娠间质激光治疗减胎术的幸存者。尽管有大面积皮肤损伤,我们仍能够对该病例进行保守处理。5岁时的随访显示瘢痕极小,且无运动功能受限。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dfc/5645009/af33cdfb3093/gr1.jpg

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