Coleman B G, Grumbach K, Arger P H, Mintz M C, Arenson R L, Mennuti M, Gabbe S G
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Radiology. 1987 Nov;165(2):449-53. doi: 10.1148/radiology.165.2.3310098.
An evaluation of 227 consecutive twin gestations was undertaken to assess the role of ultrasound (US) in the diagnosis of major obstetric complications and congenital anomalies. US accurately depicted the growth and development of fetuses in 65 patients with underlying maternal disorders that produced additional risks to the pregnancy. Complications such as malpresentations (104 cases), polyhydramnios (15 cases), oligohydramnios (five cases), and uterine myomas (seven of 11 cases) were demonstrated prenatally with US. Fetal anomalies included anencephaly (two cases), hydrocephalus (two cases), conjoined twins (three cases), twin-twin transfusion syndrome (five cases), and acardiac monsters (two cases). Demise of one twin in 20 gestations and demise of both twins in 18 gestations (overall mortality of 17%) were correctly identified with US. These 38 gestations included intrauterine demise in 12, spontaneous abortion in 13, and neonatal deaths in 13. Therefore, when multiple gestations are suspected clinically, serial real-time US scans should be obtained beginning in the first trimester.
对227例连续双胎妊娠进行了评估，以评估超声（US）在诊断主要产科并发症和先天性异常中的作用。超声准确描绘了65例患有对妊娠产生额外风险的潜在母体疾病患者胎儿的生长发育情况。超声产前显示了诸如胎位异常（104例）、羊水过多（15例）、羊水过少（5例）和子宫肌瘤（11例中的7例）等并发症。胎儿异常包括无脑儿（2例）、脑积水（2例）、联体双胎（3例）、双胎输血综合征（5例）和无心畸胎（2例）。超声正确识别了20例妊娠中一胎死亡和18例妊娠中两胎死亡（总死亡率为17%）。这38例妊娠包括12例宫内死亡、13例自然流产和13例新生儿死亡。因此，当临床上怀疑为多胎妊娠时，应从孕早期开始进行系列实时超声扫描。
