Institute for the Care of Mother and Child - Neonatology, Podolské nábřeží 157/36, Prague 14700, Czech Republic; 3rd Faculty of Medicine - Charles University, Ruská 2411/87, Prague 10000, Czech Republic.
Institute for the Care of Mother and Child - Neonatology, Podolské nábřeží 157/36, Prague 14700, Czech Republic; 3rd Faculty of Medicine - Charles University, Ruská 2411/87, Prague 10000, Czech Republic.
Early Hum Dev. 2020 May;144:105025. doi: 10.1016/j.earlhumdev.2020.105025. Epub 2020 Apr 13.
Cerebral oxygenation (crSO) monitoring is increasingly used in high-risk infants. Monochorionic twins suffer from specific fetal pathologies that can affect cerebral hemodynamics. Limited data are available on crSO and blood flow patterns in this population after birth.
To evaluate crSO changes in preterm monochorionic and dichorionic twins during the first 72 h of life.
Near-infrared spectroscopy was used to measure crSO in 62 infants from 31 twin pregnancies <32 weeks of gestation. The study group was divided into 4 subgroups: donor (1) and recipient (2) monochorionic twins (with twin-twin transfusion syndrome), fetal growth restriction (FGR) infants (3) and twins without fetal compromise (4).
There was significant difference in birth weight (p < 0.001) among 4 subgroups. We observed significant variation in crSO among the subgroups using mixed model analysis (p < 0.001). The recipient twins exhibited the lowest crSO (mean ± SE) throughout the study period (76 ± 0.3%), whereas the FGR and donor twins presented with the highest values (86 ± 0.3% and 83 ± 0.4% respectively). We found no statistically significant differences in neonatal mortality and morbidity among subgroups.
Our study revealed significant correlation between crSO values postnatally and underlying fetal pathology in monochorionic and dichorionic preterm twins.
脑氧合（crSO）监测在高危婴儿中越来越多地使用。单绒毛膜双胞胎患有特定的胎儿病理，可能影响大脑血液动力学。关于出生后该人群的 crSO 和血流模式，仅有有限的数据。
评估早产儿单绒毛膜和双绒毛膜双胞胎在出生后 72 小时内的 crSO 变化。
近红外光谱法用于测量 31 例妊娠<32 周的 62 例双胎婴儿的 crSO。研究组分为 4 个亚组：供体（1）和受体（2）单绒毛膜双胞胎（有双胎输血综合征）、胎儿生长受限（FGR）婴儿（3）和无胎儿并发症的双胞胎（4）。
4 个亚组的出生体重存在显著差异（p<0.001）。使用混合模型分析，我们观察到 crSO 在亚组之间存在显著差异（p<0.001）。受体双胞胎在整个研究期间表现出最低的 crSO（均值±SE）（76±0.3%），而 FGR 和供体双胞胎的 crSO 值最高（分别为 86±0.3%和 83±0.4%）。我们没有发现亚组之间新生儿死亡率和发病率有统计学差异。
我们的研究表明，单绒毛膜和双绒毛膜早产儿双胞胎 crSO 值与潜在的胎儿病理之间存在显著相关性。
