Lemery D R, Santolaya-Forgas J, Serre A F, Besse G H, Jacquetin B
Service de Gynécologie-Obstétrique I, Maternité de l'Hôtel-Dieu, Université d'Auvergne, France.
Fetal Diagn Ther. 1995 Mar-Apr;10(2):86-91. doi: 10.1159/000264211.
Ten sets of diamniotic twins with discordant fetal growth (ultrasonographic estimated fetal weight difference > 25%) and abnormal amniotic fluid volume were assessed for fetal serum erythropoietin concentration (Epo). All 20 fetuses had a percutaneous umbilical blood sampling performed between 21 and 33 weeks gestation. Three sets of twins were dichorionic while 7 sets were monochorionic. In these 7 monochorionic sets a vascular communication between twins was demonstrated prenatally and postnatally. From 24 weeks gestation the smaller twin of the dichorionic group had a higher serum Epo than its larger cotwin; the larger cotwin's serum Epo was within normal limits for singleton controls. All fetuses with documented vascular communications had higher serum Epo concentration than singleton controls. These findings suggest that determination of fetal serum Epo in the large cotwin may be a clue to the diagnosis of vascular communications between twins with discordant growth.
对十组双羊膜囊双胎进行了评估，这些双胎存在胎儿生长不一致（超声估计胎儿体重差异>25%）且羊水量异常，检测其胎儿血清促红细胞生成素浓度（Epo）。所有20例胎儿均在妊娠21至33周期间进行了经皮脐血采样。其中三组双胎为双绒毛膜性，七组为单绒毛膜性。在这七组单绒毛膜性双胎中，产前和产后均证实双胎之间存在血管交通。从妊娠24周起，双绒毛膜性双胎组中较小的胎儿血清Epo高于其较大的同胞胎儿；较大同胞胎儿的血清Epo在单胎对照的正常范围内。所有记录有血管交通的胎儿血清Epo浓度均高于单胎对照。这些发现表明，检测较大胎儿的血清Epo可能是诊断生长不一致双胎之间血管交通的一个线索。
