Enbom J A
Am J Obstet Gynecol. 1985 Jun 15;152(4):424-9. doi: 10.1016/s0002-9378(85)80152-6.
The antepartum death of one twin is a rare obstetric complication. Two cases are presented, accompanied by a review of the current literature. The premature and neonatal death rates are high in the surviving twins. Toxemia, fetal distress, abnormal presentation, and dystocia are also increased. Maternal disseminated intravascular coagulation has been demonstrated without a concomitant fetal coagulation defect. A more unique finding is fetal disseminated intravascular coagulation with a monochorionic placenta. The common circulation between the live and dead twins may result in fetal cerebral, renal, and cutaneous lesions, usually without demonstrable maternal disease. High-risk obstetric management is reviewed and a careful pediatric follow-up is recommended with monozygotic twins.
单胎妊娠中一个胎儿的产前死亡是一种罕见的产科并发症。本文报告两例病例，并对当前文献进行综述。存活胎儿的早产率和新生儿死亡率较高。毒血症、胎儿窘迫、胎位异常和难产的发生率也有所增加。已证实产妇发生弥散性血管内凝血，但胎儿无相应的凝血缺陷。一个更独特的发现是单绒毛膜胎盘的胎儿发生弥散性血管内凝血。存活胎儿与死亡胎儿之间的共同循环可能导致胎儿脑、肾和皮肤病变，而产妇通常无明显疾病。本文对高危产科管理进行了综述，并建议对单卵双胎进行仔细的儿科随访。
