Healey M G
Department of Obstetrics and Gynaecology, Monash Medical Centre, Melbourne, Victoria, Australia.
Teratology. 1994 Sep;50(3):205-13. doi: 10.1002/tera.1420500306.
This study aimed to find factors in acardiac pregnancies that could be used to predict survival rates of the pump fetus. Five cases of acardia at Monash Medical Centre were found, and all case reports available in the literature from 1960 to 1991 (184 cases) were collected and analyzed. Acardia is more common in nulliparous women and in monoamniotic monochorionic pregnancy. The acardiac fetus usually has a two-vessel umbilical cord and is most likely to develop structures supplied by the lower aortic branches. Delivery is more often preterm (mean gestation = 31.1 weeks) than normal twins. The overall perinatal mortality for the pump fetus is 35% in twins and 45% in triplets. Factors associated with a statistically significant increase in perinatal mortality for the pump fetus include delivery before 32 weeks gestation, acardiacus anceps form of acardia, and the presence of arms, ears, larynx, trachea, pancreas, kidney, or small intestine in the acardiac fetus. Active intervention in these pregnancies is reasonable.
本研究旨在找出无心畸胎妊娠中可用于预测泵血胎儿存活率的因素。在莫纳什医疗中心发现了5例无心畸胎病例，并收集分析了1960年至1991年文献中所有可用的病例报告（184例）。无心畸胎在初产妇和单羊膜单绒毛膜妊娠中更为常见。无心胎儿通常有一条双脐动脉，最有可能发育由降主动脉分支供应的结构。分娩往往比正常双胞胎早产（平均孕周=31.1周）。泵血胎儿的总体围产期死亡率在双胞胎中为35%，在三胞胎中为45%。与泵血胎儿围产期死亡率统计学显著增加相关的因素包括妊娠32周前分娩、无心畸胎的双头无心畸形形式，以及无心胎儿存在手臂、耳朵、喉、气管、胰腺、肾脏或小肠。对这些妊娠进行积极干预是合理的。
