Bowman J M
Am J Obstet Gynecol. 1985 Sep 1;153(1):7-13. doi: 10.1016/0002-9378(85)90581-2.
Of 118 twins born of 59 alloimmunized mothers from 1944 to 1984, 65 were Rh-positive and six died. One twin in one of the 59 sets and four sets of twins referred from elsewhere underwent intrauterine fetal transfusion. The Manitoba twin and two pairs of the four referred sets survived. Fetal transfusions were begun at 22 2/7 and 24 1/7 weeks' gestation in one surviving set and 23 3/7 weeks in both twins of the other surviving set. Three twins of the four who died were hydropic at referral. There would have been a 62.5% chance of survival if they had been referred at 23 weeks' gestation. ABO incompatibility in one twin of three sets had no effect on the amelioration of severity of Rh disease. In three sets, gross hemoglobin disparities were due to twin-to-twin transfusion. Differences in degree of severity of disease in the other four dichorionic sets may have been due to differences in sex, Rh constitution, amount of fetal erythropoiesis, and fetal hepatocellular function.
在1944年至1984年间，59名发生同种免疫的母亲所生的118对双胞胎中，65名是Rh阳性，6名死亡。59组双胞胎中有一组的一名双胞胎以及从其他地方转诊来的4组双胞胎接受了宫内胎儿输血。曼尼托巴省的那组双胞胎以及转诊来的4组中的两组双胞胎存活了下来。一组存活的双胞胎在妊娠22又2/7周和24又1/7周开始进行胎儿输血，另一组存活的双胞胎在妊娠23又3/7周时开始对两个胎儿都进行输血。转诊时，死亡的4名双胞胎中有3名出现水肿。如果他们在妊娠23周时转诊，存活几率本会有62.5%。3组双胞胎中有一组的一名双胞胎存在ABO血型不合，但这对减轻Rh疾病的严重程度没有影响。在3组中，血红蛋白总量的差异是由于双胎输血造成的。其他4组双绒毛膜双胞胎疾病严重程度的差异可能是由于性别、Rh构成、胎儿红细胞生成量以及胎儿肝细胞功能的不同。
