Hecher K, Ville Y, Snijders R, Nicolaides K
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School, London, UK.
Ultrasound Obstet Gynecol. 1995 May;5(5):318-24. doi: 10.1046/j.1469-0705.1995.05050318.x.
This cross-sectional study investigated the circulatory profile of the donor and recipient fetuses in 20 pregnancies with twin-twin transfusion syndrome presenting with acute polyhydramnios at 17-27 (mean, 22) weeks' gestation. Doppler investigations of the arterial vessels and ductus venosus, inferior vena cava, right hepatic vein, tricuspid and mitral ventricular inflow were performed in both fetuses. Mean values of most blood flow velocities on the venous side showed a significant decrease in both groups of fetuses, and a significant increase in mean values for indices describing waveform pulsatility was found in all three venous vessels in the group of recipients, whereas in the donor group this was only the case in the ductus venosus. Mean values of atrioventricular flow velocities showed a significant decrease in the donor group. The most significant findings on the arterial side were an increased mean umbilical artery pulsatility index and a decreased mean value for aortic blood flow velocity in both groups of fetuses. Five recipients and four donors had absence or reversal of blood flow during atrial contraction in the ductus venosus. All these fetuses showed pulsations in the umbilical vein. Tricuspid regurgitation was present in eight recipients. Absence or reversal of end-diastolic velocities in the umbilical artery was found in four donors.(ABSTRACT TRUNCATED AT 250 WORDS)
这项横断面研究调查了20例双胎输血综合征孕妇中供体和受体胎儿的循环特征，这些孕妇在妊娠17 - 27周（平均22周）时出现急性羊水过多。对两个胎儿均进行了动脉血管、静脉导管、下腔静脉、右肝静脉、三尖瓣和二尖瓣心室流入道的多普勒检查。两组胎儿静脉侧大多数血流速度的平均值均显著降低，受体组所有三条静脉血管中描述波形搏动性的指标平均值显著升高，而供体组仅静脉导管出现这种情况。供体组房室血流速度平均值显著降低。动脉侧最显著的发现是两组胎儿的平均脐动脉搏动指数升高，主动脉血流速度平均值降低。5例受体和4例供体的静脉导管在心房收缩期出现血流缺失或反向。所有这些胎儿的脐静脉均有搏动。8例受体存在三尖瓣反流。4例供体的脐动脉舒张末期速度缺失或反向。（摘要截选至250字）
