• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

基于多普勒的单绒毛膜-双羊膜囊双胎妊娠胎儿心循环指数的参考值。

Reference values for fetal Doppler-based cardiocirculatory indices in monochorionic-diamniotic twin pregnancy.

机构信息

Siriraj Fetal Therapy Center (SiFTC), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Siriraj, Bangkoknoi, Bangkok, 10700, Thailand.

出版信息

BMC Pregnancy Childbirth. 2021 Nov 30;21(1):797. doi: 10.1186/s12884-021-04255-w.

DOI:10.1186/s12884-021-04255-w
PMID:34847869
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8630902/
Abstract

BACKGROUND

Placental anastomoses in monochorionic diamniotic (MCDA) twin pregnancy have a major impact on fetal circulation. This study was designed to define reference ranges of cardiac and vascular Doppler indices in MCDA twin pregnancies.

METHODS

This cross-sectional study included 442 uncomplicated MCDA twin fetuses undergoing Doppler ultrasonography at 18-35 weeks of gestation. Left and right myocardial performance index (LV-MPI, RV-MPI), E/A ratio of atrioventricular valves, pulsatility indices of umbilical artery, middle cerebral artery (MCA), and ductus venosus (DV), cerebroplacental ratio, peak systolic velocity of MCA, S/a ratio of DV, and early diastolic filling time of ductus venosus (DV-E) were evaluated under standardized settings. The equation models between Doppler indices and gestational age (GA) were fitted. After adjustment for GA, the correlations between MPI and fetal heart rate (FHR), and between MPI and DV indices were analyzed.

RESULTS

Estimated centiles of Doppler indices were derived as a function of GA, being distinct in values from those of singletons. There was no correlation between GA-adjusted MPI and FHR. DV-E was inversely related to LV-MPI.

CONCLUSIONS

MCDA twins showed significant changes in some Doppler indices throughout gestation with quantitative differences from singletons, emphasizing the importance of MC twin-specific reference values for clinical application. Further adjustment of MPI for FHR was unnecessary. DV-E is a vascular index indirectly representing fetal diastolic function.

摘要

背景

单绒毛膜双羊膜囊（MCDA）双胎妊娠中的胎盘吻合对胎儿循环有重大影响。本研究旨在确定 MCDA 双胎妊娠中心血管多普勒指数的参考范围。

方法

本横断面研究纳入了 442 例在 18-35 孕周行多普勒超声检查的无并发症 MCDA 双胎胎儿。在标准化设置下评估左、右心肌性能指数（LV-MPI、RV-MPI）、房室瓣 E/A 比值、脐动脉、大脑中动脉（MCA）和静脉导管（DV）的搏动指数、脑胎盘比、MCA 收缩期峰值速度、DV 的 S/a 比值和静脉导管早期舒张填充时间（DV-E）。拟合了多普勒指数与胎龄（GA）之间的方程模型。在调整 GA 后，分析了 MPI 与胎心率（FHR）之间的相关性，以及 MPI 与 DV 指数之间的相关性。

结果

以 GA 为函数得出了多普勒指数的估计百分位数，其值与单胎明显不同。GA 调整后的 MPI 与 FHR 之间无相关性。DV-E 与 LV-MPI 呈负相关。

结论

MCDA 双胞胎在整个孕期的一些多普勒指数发生了显著变化，与单胎相比存在定量差异，强调了 MC 双胞胎特异性参考值在临床应用中的重要性。进一步调整 MPI 以适应 FHR 是不必要的。DV-E 是一个间接反映胎儿舒张功能的血管指数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54cd/8630902/b9d407a3de88/12884_2021_4255_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54cd/8630902/ded4707b66b2/12884_2021_4255_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54cd/8630902/691e2521e638/12884_2021_4255_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54cd/8630902/a32541798bde/12884_2021_4255_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54cd/8630902/1da16745826c/12884_2021_4255_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54cd/8630902/b9d407a3de88/12884_2021_4255_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54cd/8630902/ded4707b66b2/12884_2021_4255_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54cd/8630902/691e2521e638/12884_2021_4255_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54cd/8630902/a32541798bde/12884_2021_4255_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54cd/8630902/1da16745826c/12884_2021_4255_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54cd/8630902/b9d407a3de88/12884_2021_4255_Fig5_HTML.jpg

相似文献

1
Reference values for fetal Doppler-based cardiocirculatory indices in monochorionic-diamniotic twin pregnancy.基于多普勒的单绒毛膜-双羊膜囊双胎妊娠胎儿心循环指数的参考值。
BMC Pregnancy Childbirth. 2021 Nov 30;21(1):797. doi: 10.1186/s12884-021-04255-w.
2
Fetal ventricular strain in uncomplicated and selective growth-restricted monochorionic diamniotic twin pregnancies and cardiovascular response in pre-twin-twin transfusion syndrome.单纯性及选择性生长受限的单绒毛膜双羊膜囊双胎胎儿心室应变与双胎输血综合征前的心血管反应
Ultrasound Obstet Gynecol. 2020 Nov;56(5):694-704. doi: 10.1002/uog.21911.
3
Prediction of adverse pregnancy outcome in monochorionic diamniotic twin pregnancy complicated by selective fetal growth restriction.预测单纯性双羊膜囊双胎妊娠并发选择性胎儿生长受限的不良妊娠结局。
Ultrasound Obstet Gynecol. 2019 Feb;53(2):200-207. doi: 10.1002/uog.19078.
4
Umbilical and fetal middle cerebral artery Doppler reference ranges in a twin population followed longitudinally from 24 to 38 weeks' gestation.脐带动脉和胎儿大脑中动脉多普勒参考范围在 24 周至 38 周妊娠的双胎人群中的纵向研究。
Ultrasound Obstet Gynecol. 2014 Oct;44(4):461-7. doi: 10.1002/uog.13302. Epub 2014 Sep 5.
5
Longitudinal Doppler references for monochorionic twins and comparison with singletons.单绒毛膜性双胎的纵向多普勒参考值与单胎比较。
PLoS One. 2019 Dec 6;14(12):e0226090. doi: 10.1371/journal.pone.0226090. eCollection 2019.
6
Three-dimensional power Doppler ultrasound evaluation of placental blood flow in normal monochorionic diamniotic twin pregnancies.正常单绒毛膜双羊膜囊双胎妊娠胎盘血流的三维能量多普勒超声评估。
BMC Pregnancy Childbirth. 2018 Nov 14;18(1):443. doi: 10.1186/s12884-018-2080-y.
7
Perinatal outcome of monochorionic diamniotic twin pregnancy complicated by selective intrauterine growth restriction according to umbilical artery Doppler flow pattern: single-center study using strict fetal surveillance protocol.根据脐动脉多普勒血流模式评估，采用严格胎儿监测方案的单中心研究：单纯性胎儿生长受限的复杂性单绒毛膜双羊膜囊双胎的围产儿结局。
Ultrasound Obstet Gynecol. 2021 May;57(5):748-755. doi: 10.1002/uog.22128.
8
Reference ranges for middle cerebral artery peak systolic velocity in monochorionic diamniotic twins: a longitudinal study.单绒毛膜双胎胎儿大脑中动脉收缩期峰值速度的参考范围：一项纵向研究。
Ultrasound Obstet Gynecol. 2009 Aug;34(2):149-54. doi: 10.1002/uog.6436.
9
Fetal cardiac parameters for prediction of twin-to-twin transfusion syndrome.胎儿心脏参数预测双胎输血综合征。
Ultrasound Obstet Gynecol. 2014 Oct;44(4):434-40. doi: 10.1002/uog.13442. Epub 2014 Sep 10.
10
Maternal Utero-Placental Perfusion Discordance in Monochorionic-Diamniotic Twin Pregnancies with Selective Growth Restriction Assessed by Three-Dimensional Power Doppler Ultrasound.三维能量多普勒超声评估选择性生长受限的单绒毛膜-双羊膜囊双胎妊娠的母体-胎盘灌注差异。
Med Sci Monit. 2020 Jan 23;26:e919247. doi: 10.12659/MSM.919247.

本文引用的文献

1
Outcome of twin-twin transfusion syndrome according to Quintero stage of disease: systematic review and meta-analysis.根据疾病的 Quintero 分期评估双胎输血综合征的结局：系统评价和荟萃分析。
Ultrasound Obstet Gynecol. 2020 Dec;56(6):811-820. doi: 10.1002/uog.22054. Epub 2020 Nov 12.
2
Longitudinal Doppler references for monochorionic twins and comparison with singletons.单绒毛膜性双胎的纵向多普勒参考值与单胎比较。
PLoS One. 2019 Dec 6;14(12):e0226090. doi: 10.1371/journal.pone.0226090. eCollection 2019.
3
Reference ranges for the left ventricle modified myocardial performance index, respective time periods, and atrioventricular peak velocities between 20 and 36 + 6 weeks of gestation.
20 至 36+6 孕周左心室改良心肌做功指数、各自时相及房室瓣口血流速度的参考范围。
J Matern Fetal Neonatal Med. 2021 Feb;34(3):456-465. doi: 10.1080/14767058.2019.1609933. Epub 2019 May 2.
4
Fetal Medicine Foundation reference ranges for umbilical artery and middle cerebral artery pulsatility index and cerebroplacental ratio.胎儿医学基金会的脐动脉和大脑中动脉搏动指数及脑胎盘比值参考范围。
Ultrasound Obstet Gynecol. 2019 Apr;53(4):465-472. doi: 10.1002/uog.20157. Epub 2019 Feb 13.
5
Time Interval Measurements of the Ductus Venosus During the Early Second Trimester of Pregnancy: Reference Ranges and Clinical Application.孕中期早期静脉导管的时间间隔测量：参考范围及临床应用
J Ultrasound Med. 2018 Mar;37(3):745-753. doi: 10.1002/jum.14409. Epub 2017 Sep 26.
6
Outcome of monochorionic twin pregnancy with selective intrauterine growth restriction according to umbilical artery Doppler flow pattern of smaller twin: systematic review and meta-analysis.根据较小双胞胎的脐动脉多普勒血流模式评估单绒毛膜双胎妊娠选择性宫内生长受限的结局：系统评价和荟萃分析。
Ultrasound Obstet Gynecol. 2017 Nov;50(5):559-568. doi: 10.1002/uog.17362.
7
Diagnostic accuracy of ultrasound in predicting birth-weight discordance in twin pregnancy: systematic review and meta-analysis.超声预测双胎妊娠出生体重不一致的诊断准确性：系统评价和荟萃分析。
Ultrasound Obstet Gynecol. 2017 Oct;50(4):442-450. doi: 10.1002/uog.17348.
8
Cardiac Manifestations of Twin-to-Twin Transfusion Syndrome.双胎输血综合征的心脏表现
Twin Res Hum Genet. 2016 Jun;19(3):246-54. doi: 10.1017/thg.2016.20. Epub 2016 Apr 18.
9
Reference Values and Z Scores for Pulsed-Wave Doppler and M-Mode Measurements in Fetal Echocardiography.胎儿超声心动图中脉冲波多普勒和M型测量的参考值及Z评分
J Am Soc Echocardiogr. 2016 May;29(5):448-460.e9. doi: 10.1016/j.echo.2016.01.002. Epub 2016 Mar 9.
10
Fetal growth reference ranges in twin pregnancy: analysis of the Southwest Thames Obstetric Research Collaborative (STORK) multiple pregnancy cohort.双胎妊娠的胎儿生长参考范围：西南泰晤士河产科研究协作组（STORK）多胎妊娠队列分析
Ultrasound Obstet Gynecol. 2015 Mar;45(3):301-7. doi: 10.1002/uog.14640. Epub 2014 Aug 25.