Berry S M, Puder K S, Bottoms S F, Uckele J E, Romero R, Cotton D B
Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, MI 48201, USA.
Am J Obstet Gynecol. 1995 May;172(5):1403-10. doi: 10.1016/0002-9378(95)90469-7.
Our purpose was to compare hematologic and biochemical values in cordocentesis specimens from twin pairs with and without stuck twin syndrome.
Cordocentesis was performed on 38 twin pairs. Assignment to the stuck twin syndrome group (n = 8) was based on ultrasonographic findings of discordant size and amniotic fluid volume, concordant gender, and a single placenta. A receiver-operator characteristic curve was constructed with the use of intertwin hemoglobin differences. For the stuck twin syndrome group regression analysis of gestational age and intertwin hemoglobin difference was done.
We found significant (p = 0.03) intertwin differences in hemoglobin between the stuck twin syndrome group (mean 5.35 gm/dl, range 0.5 to 15.4 gm/dl) and the comparison group (mean 0.10 gm/dl, range 0.0 to 2.4 gm/dl). A nearly significant relationship between gestational age and intertwin hemoglobin difference was noted in the stuck twin syndrome group. When the hemoglobin difference was > 2.4 gm/dl, all cases had stuck twin syndrome (sensitivity = 50%, specificity = 100%, positive predictive value = 100%, negative predictive value = 91%). In the stuck twin syndrome group there was a trend toward larger intertwin differences in albumin and total protein. Intertwin blood gas values between the groups did not differ, but the average PO2 was lower when the smaller twins of the two groups were compared.
An intertwin difference in hemoglobin > 2.4 gm/dl is consistent with stuck twin syndrome. Large intertwin hemoglobin differences and imbalances in albumin and total protein may be seen in stuck twin syndrome.
我们的目的是比较患有和未患有黏连双胎综合征的双胎对脐血穿刺样本中的血液学和生化指标。
对38对双胎进行了脐血穿刺。根据超声检查结果，即大小和羊水量不一致、性别一致且胎盘单一，将其分配到黏连双胎综合征组（n = 8）。利用双胎间血红蛋白差异构建了受试者工作特征曲线。对黏连双胎综合征组进行了胎龄与双胎间血红蛋白差异的回归分析。
我们发现黏连双胎综合征组（平均5.35 g/dl，范围0.5至15.4 g/dl）与对照组（平均0.10 g/dl，范围0.0至2.4 g/dl）之间双胎间血红蛋白存在显著差异（p = 0.03）。在黏连双胎综合征组中，胎龄与双胎间血红蛋白差异之间存在近乎显著的关系。当血红蛋白差异> 2.4 g/dl时，所有病例均患有黏连双胎综合征（敏感性 = 50%，特异性 = 100%，阳性预测值 = 100%，阴性预测值 = 91%）。在黏连双胎综合征组中，白蛋白和总蛋白的双胎间差异有增大的趋势。两组间双胎血气值无差异，但比较两组中较小双胎时，平均PO2较低。
双胎间血红蛋白差异> 2.4 g/dl与黏连双胎综合征相符。黏连双胎综合征中可能出现双胎间血红蛋白差异大以及白蛋白和总蛋白失衡的情况。
