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产前超声在联体双胎中的应用价值

The application value of prenatal ultrasound in conjoined twins.

作者信息

Xiao Juhua, Liao Kun, Tan Zhiwen, Xie Jiping, Lai Hua, Zhang Shouhua, Luo Ye

机构信息

Department of Ultrasound, Jiangxi Maternal and Child Health Hospital, Nanchang, China.

Jiangxi Key Laboratory of Reproductive Health (No. 2024SSY06211), Nanchang, China.

出版信息

J Clin Ultrasound. 2025 Jan;53(1):122-128. doi: 10.1002/jcu.23851. Epub 2024 Sep 19.

Abstract

OBJECTIVE

To evaluate the application and effectiveness of prenatal ultrasound in diagnosing and managing conjoined twins.

METHODS

A retrospective analysis was conducted on 20 cases of conjoined twins diagnosed at our hospital between January 2016 and December 2022. The types of conjoined twins, ultrasonographic characteristics, and associated anomalies were assessed.

RESULTS

The gestational age at diagnosis ranged from 10 to 35 weeks, with an average of 14.21 ± 5.69 weeks. Thirteen cases were detected in the first trimester, five in the early second trimester, one at 23 + 2 weeks, and one at 35 weeks. Thoracopagus was the most common type (11 cases, 55%), followed by omphalopagus (4 cases, 20%), cephalopagus (4 cases, 20%), and parapagus dicephalus (1 case, 5%). In the first trimester, the most common abnormalities observed included increased nuchal translucency (NT), cystic hygroma, hydrops fetalis, and generalized edema. Major birth defects identified in conjoined twins were omphalocele (3 cases), congenital heart malformations (3 cases), neural tube defects (2 cases), urachal cyst (1 case), and umbilical cyst (1 case). Pregnancy was terminated in 18 cases, one case resulted in spontaneous abortion during the second trimester, and one case was delivered by cesarean section at 37 weeks, with successful separation and recovery.

CONCLUSION

Prenatal ultrasound is the primary diagnostic tool for conjoined twins. It effectively assesses the extent of twin fusion, provides critical information for clinical decision-making, and aids in the management of obstetric care.

摘要

目的

评估产前超声在联体双胎诊断及处理中的应用及效果。

方法

对2016年1月至2022年12月在我院诊断的20例联体双胎病例进行回顾性分析。评估联体双胎的类型、超声特征及相关异常情况。

结果

诊断时的孕周为10至35周,平均为14.21±5.69周。孕早期检出13例,孕中期早期检出5例,孕23⁺²周检出1例,孕35周检出1例。胸腹联体是最常见的类型(11例,55%),其次是脐联体(4例,20%)、头联体(4例,20%)和双头侧联体(1例,5%)。孕早期观察到的最常见异常包括颈项透明层(NT)增厚、囊性水瘤、胎儿水肿和全身水肿。联体双胎中发现的主要出生缺陷有脐膨出(3例)、先天性心脏畸形(3例)、神经管缺陷(2例)、脐尿管囊肿(1例)和脐囊肿(1例)。18例终止妊娠,1例在孕中期自然流产,1例在孕37周剖宫产分娩,分离成功且恢复良好。

结论

产前超声是联体双胎的主要诊断工具。它能有效评估双胎融合程度,为临床决策提供关键信息,并有助于产科护理管理。

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