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双胎妊娠管理中的争议。

Controversies in the management of twin pregnancy.

机构信息

Twins Trust Centre for Research and Clinical Excellence, St George's University Hospitals NHS Foundation Trust, London, UK.

Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK.

出版信息

Ultrasound Obstet Gynecol. 2021 Jun;57(6):888-902. doi: 10.1002/uog.22181. Epub 2021 May 21.

Abstract

Despite many advances in antenatal care, twin pregnancies still experience more adverse outcomes, in particular perinatal morbidity and mortality. They also pose a multitude of challenges and controversies, as outlined in this Review. Moreover, they are less likely to be included in clinical trials. Many issues on classification and management remain under debate. Efforts at standardizing diagnostic criteria, monitoring protocols, management and outcome reporting are likely to reduce their perinatal risks. The top 10 most important research uncertainties related to multiple pregnancies have been identified by both clinicians and patients. More robust research in the form of randomized trials and large well-conducted prospective cohort studies is needed to address these controversies. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

摘要

尽管产前护理有了许多进步,但双胞胎妊娠仍会出现更多不良结局,尤其是围产期发病率和死亡率。如本综述所述,它们还带来了许多挑战和争议。此外,它们不太可能被纳入临床试验。关于分类和管理的许多问题仍存在争议。努力使诊断标准、监测方案、管理和结果报告标准化,可能会降低其围产期风险。临床医生和患者都确定了与多胎妊娠相关的前 10 个最重要的研究不确定性问题。需要更多以随机试验和精心设计的大型前瞻性队列研究的形式开展更有力的研究,以解决这些争议。© 2020 作者。超声在妇产科由约翰威立父子有限公司代表国际妇产科超声学会出版。

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