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孕早期超声筛查孕28周前双胎妊娠不良胎儿结局的独立危险因素。

Independent risk factors for twin pregnancy adverse fetal outcomes before 28 gestational week by first trimester ultrasound screening.

作者信息

Zhang Hui-Ping, Bao Li, Wu Jing-Jing, Zhou Yu-Qing

机构信息

Department of Ultrasound, Shanghai Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai 200050, China.

出版信息

World J Radiol. 2025 Jan 28;17(1):103111. doi: 10.4329/wjr.v17.i1.103111.

Abstract

BACKGROUND

The incidence of multiple pregnancies has increased worldwide recently and women with a twin pregnancy are at higher risk of adverse outcomes compared with women with a singleton pregnancy. It is important to understand the risk factors for adverse fetal outcomes in twin pregnancy in order to guide clinical management.

AIM

To identify the independent risk factors, including maternal personal and family medical histories and first trimester ultrasound screening findings, for adverse fetal outcomes of twin pregnancy before 28 weeks of gestation.

METHODS

The data of 126 twin pregnancies in our hospital, including pregnancy outcomes, first trimester ultrasound screening findings and maternal medical history, were retrospectively collected. Twenty-nine women with adverse outcomes were included in the abnormal group and the remaining 97 women were included in the control group.

RESULTS

Patients in the abnormal group were more likely to be monochorionic diamniotic (13/29 20/97, = 0.009), with a higher mean pulsatility index (PI, 1.57 ± 0.55 1.28 ± 0.42, = 0.003; cutoff value: 1.393) or a higher mean resistance index (0.71 ± 0.11 0.65 ± 0.11, = 0.008; cutoff value: 0.683) or early diastolic notch of bilateral uterine arteries (UtAs, 10/29 15/97, = 0.024) or with abnormal ultrasound findings (13/29 2/97, < 0.001), compared with the control group. Monochorionic diamnioticity, higher mean PI of bilateral UtAs and abnormal ultrasound findings during first trimester screening were independent risk factors for adverse fetal outcomes ( < 0.05).

CONCLUSION

First trimester ultrasound screening for twin pregnancy identifies independent risk factors and is useful for the prediction of fetal outcomes.

摘要

背景

近年来,全球多胎妊娠的发生率有所上升,与单胎妊娠女性相比,双胎妊娠女性出现不良结局的风险更高。了解双胎妊娠胎儿不良结局的风险因素对于指导临床管理至关重要。

目的

确定妊娠28周前双胎妊娠胎儿不良结局的独立风险因素,包括母亲个人和家族病史以及孕早期超声筛查结果。

方法

回顾性收集我院126例双胎妊娠的数据,包括妊娠结局、孕早期超声筛查结果和母亲病史。29例出现不良结局的女性被纳入异常组,其余97例女性被纳入对照组。

结果

与对照组相比,异常组患者更可能为单绒毛膜双羊膜囊妊娠(13/29对20/97,P = 0.009),双侧子宫动脉平均搏动指数(PI)更高(1.57±0.55对1.28±0.42,P = 0.003;临界值:1.393)或平均阻力指数更高(0.71±0.11对0.65±0.11,P = 0.008;临界值:0.683)或双侧子宫动脉舒张早期切迹(10/29对15/97,P = 0.024)或超声检查结果异常(13/29对2/97,P < 0.001)。单绒毛膜双羊膜囊妊娠、孕早期双侧子宫动脉平均PI升高和超声筛查结果异常是胎儿不良结局的独立风险因素(P < 0.05)。

结论

双胎妊娠孕早期超声筛查可确定独立风险因素,有助于预测胎儿结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f54/11755904/d5b8ed713a42/103111-g001.jpg

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