促进双绒毛膜双羊膜囊双胎妊娠孕周延长的最佳管理策略。
Optimal management strategies for promoting gestational extension in dichorionic diamniotic twin pregnancies.
作者信息
Chen Caixia, Fan Changyou, Wang Bufei, Zhu Ping
机构信息
Department of Obstetrics and Gynaecology, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, China.
Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China.
出版信息
Front Physiol. 2024 Nov 26;15:1489780. doi: 10.3389/fphys.2024.1489780. eCollection 2024.
BACKGROUND
Preterm birth is a significant concern in multiple pregnancies, warranting effective strategies to improve outcomes. Delaying delivery of the second fetus is crucial for reducing perinatal mortality rates.
CASE PRESENTATION
In a dichorionic diamniotic twin pregnancy, one fetus experienced premature rupture of membranes (PROM) at 16+6 weeks gestation. Proactive fetal reduction through potassium chloride injection and emergency cervical cerclage at 19+1 week successfully extended the pregnancy to 39+5 weeks, resulting in a notable 160-day prolongation. Postoperative management encompassed comprehensive tocolytic therapy.
CONCLUSION
The combined approach of proactive fetal reduction and emergency cervical cerclage proved successful in managing PROM in dichorionic diamniotic twin pregnancies. This innovative strategy offers a promising clinical solution for optimizing outcomes and prolonging gestation in high-risk multiple pregnancies, underscoring the importance of tailored interventions in complex obstetric scenarios.
背景
早产是多胎妊娠中的一个重大问题，需要有效的策略来改善结局。延迟第二个胎儿的分娩对于降低围产期死亡率至关重要。
病例介绍
在双绒毛膜双羊膜囊双胎妊娠中，一个胎儿在妊娠16+6周时发生胎膜早破（PROM）。在19+1周时通过氯化钾注射进行主动减胎和紧急宫颈环扎术成功将孕周延长至39+5周，延长了160天。术后管理包括全面的宫缩抑制治疗。
结论
主动减胎和紧急宫颈环扎术相结合的方法在双绒毛膜双羊膜囊双胎妊娠中处理胎膜早破方面被证明是成功的。这种创新策略为优化高危多胎妊娠的结局和延长孕周提供了一个有前景的临床解决方案，强调了在复杂产科情况下进行针对性干预的重要性。
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