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本文引用的文献

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Management of Monochorionic Twin Pregnancy: Green-top Guideline No. 51.单绒毛膜双胎妊娠的管理:第51号绿色指南
BJOG. 2017 Jan;124(1):e1-e45. doi: 10.1111/1471-0528.14188. Epub 2016 Nov 16.
2
Diagnosis and Management of Complicated Monochorionic Twins.复杂性单绒毛膜双胎的诊断与管理
Clin Obstet Gynecol. 2015 Sep;58(3):632-42. doi: 10.1097/GRF.0000000000000127.
3
Fibrinogen levels in the late stage of twin pregnancy.双胎妊娠晚期的纤维蛋白原水平。
Thromb Res. 2015 Feb;135(2):318-21. doi: 10.1016/j.thromres.2014.11.030. Epub 2014 Dec 4.
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Twin-twin transfusion syndrome.双胎输血综合征。
Am J Obstet Gynecol. 2013 Jan;208(1):3-18. doi: 10.1016/j.ajog.2012.10.880. Epub 2012 Nov 27.
5
Anticoagulant therapy during pregnancy for maternal and fetal acquired and inherited thrombophilia.妊娠期抗凝治疗用于母体和胎儿获得性及遗传性血栓形成倾向。
Curr Med Chem. 2012;19(27):4562-71. doi: 10.2174/092986712803306466.
6
Co-twin prognosis after single fetal death: a systematic review and meta-analysis.单胎胎儿死亡后对其存活胎儿的预后:系统评价和荟萃分析。
Obstet Gynecol. 2011 Oct;118(4):928-40. doi: 10.1097/AOG.0b013e31822f129d.
7
The association of factor V leiden and prothrombin gene mutation and placenta-mediated pregnancy complications: a systematic review and meta-analysis of prospective cohort studies.因子 V 莱顿和凝血酶原基因突变与胎盘介导的妊娠并发症的关联:前瞻性队列研究的系统评价和荟萃分析。
PLoS Med. 2010 Jun 15;7(6):e1000292. doi: 10.1371/journal.pmed.1000292.
8
Incidence and clinicopathologic correlation of fetal vessel thrombosis in mono- and dichorionic twin placentas.单绒毛膜和双绒毛膜双胞胎胎盘胎儿血管血栓形成的发生率及临床病理相关性。
J Perinatol. 2010 Oct;30(10):660-4. doi: 10.1038/jp.2010.19. Epub 2010 Mar 4.
9
Unexplained fetal loss: the fetal side of thrombophilia.不明原因胎儿丢失:血栓形成倾向的胎儿方面。
Fertil Steril. 2010 Jun;94(1):378-80. doi: 10.1016/j.fertnstert.2009.09.052. Epub 2009 Nov 11.
10
Twin-to-twin transfusion syndrome: a comprehensive update.双胎输血综合征:全面更新
Clin Perinatol. 2009 Jun;36(2):391-416, x. doi: 10.1016/j.clp.2009.03.003.

单绒毛膜双胎妊娠合并双胎输血综合征的母体遗传性易栓症

Maternal Inherited Thrombophilia in Monochorionic Twin Pregnancy with Twin-Twin Transfusion Syndrome.

作者信息

Giannubilo Stefano R, Fiorelli Alessia, Marzioni Daniela, Tossetta Giovanni, Capogrosso Giulia, Ciavattini Andrea

机构信息

Department of Clinical Sciences, Polytechnic University of Marche, Salesi Hospital, Via Corridoni 11, 60123 Ancona, Italy.

Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Via Tronto, 10/a, 60126 Ancona, Italy.

出版信息

J Clin Med. 2022 Nov 29;11(23):7054. doi: 10.3390/jcm11237054.

DOI:10.3390/jcm11237054
PMID:36498629
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9736336/
Abstract

BACKGROUND

To study the frequency of inherited thrombophilia in monochorionic twin pregnancies with twin-twin transfusion syndrome (TTTS).

METHODS

At the Department of Obstetrics of the Polytechnic University of Marche (Ancona, Italy) a population of monochorionic diamniotic pregnant women was selected retrospectively. After termination of the pregnancy, genotyping for Factor I, Factor V Leiden, Factor II and Methylenetetrahydrofolate Reductase (MTHFR), as well as activities of the plasma proteins C and S, was performed.

RESULTS

Regarding the 32 patients with TTTS, from a cohort of 104 monochorionic pregnancies recruited, at least one thrombophilic defect was more frequent (OR: 3.24), and the allele polymorphism frequency was higher for Factor I (OR: 4.4) and for Factor V Leiden (OR: 11.66).

CONCLUSIONS

Maternal inherited thrombophilia, possibly also inherited from monochorial fetuses, may result in impaired development of the placental vascular architecture. This inheritance hypothesis may explain why only a fraction of monochorionic diamniotic twins develop TTTS.

摘要

背景

研究双胎输血综合征(TTTS)的单绒毛膜双胎妊娠中遗传性易栓症的发生率。

方法

在马尔凯理工大学(意大利安科纳)妇产科,回顾性选取了一群单绒毛膜双羊膜囊孕妇。妊娠终止后,进行了凝血因子I、凝血因子V莱顿突变、凝血因子II和亚甲基四氢叶酸还原酶(MTHFR)的基因分型,以及血浆蛋白C和S的活性检测。

结果

在招募的104例单绒毛膜妊娠队列中,32例TTTS患者中至少有一种易栓缺陷更为常见(比值比:3.24),凝血因子I(比值比:4.4)和凝血因子V莱顿突变(比值比:11.66)的等位基因多态性频率更高。

结论

母亲的遗传性易栓症,可能也遗传自单绒毛膜胎儿,可能导致胎盘血管结构发育受损。这种遗传假说可以解释为什么只有一小部分单绒毛膜双羊膜囊双胎会发生TTTS。