Weissman A, Achiron R, Lipitz S, Blickstein I, Mashiach S
Department of Obstetrics and Gynecology, Kaplan Hospital, Rehovot, Israel.
Obstet Gynecol. 1994 Jul;84(1):110-4.
To evaluate the clinical significance and the natural course of discordant twin growth found during the first trimester of pregnancy.
This was a retrospective survey between 1992-1993 of women presenting to the ultrasonographic unit with twin pregnancies in which considerable interfetal size variation was noted in the first trimester. Discordant embryonal growth was defined as a difference in crown-rump length corresponding to 5 or more days in the estimated gestational age. Only cases that presented with continued viability of both twins were reviewed. Cases were thoroughly followed by ultrasound examinations throughout pregnancy. Neonatal records provided the outcome data.
Five cases with first-trimester discordant twin growth were identified. All had complications of major congenital anomalies in the smaller twin, ie, diaphragmatic hernia, ventriculomegaly, schizencephaly, critical aortic atresia, and sacral agenesis.
The first-trimester growth-discordant twin is at increased risk for congenital anomalies. Meticulous sonographic search for congenital anomalies is indicated when inter-twin size variation is evident in the first trimester.
评估孕早期发现的双胎生长不一致的临床意义及自然病程。
这是一项1992年至1993年间对超声科双胎妊娠女性进行的回顾性调查，这些女性在孕早期发现胎儿间大小差异显著。不一致的胚胎生长定义为顶臀长度差异对应估计孕周5天或更多天。仅对双胎均持续存活的病例进行回顾。整个孕期通过超声检查对病例进行密切随访。新生儿记录提供结局数据。
识别出5例孕早期双胎生长不一致的病例。所有较小胎儿均有主要先天性异常并发症，即膈疝、脑室扩大、脑裂畸形、严重主动脉闭锁和骶骨发育不全。
孕早期生长不一致的双胎发生先天性异常的风险增加。当孕早期双胎间大小差异明显时，需仔细进行超声检查以寻找先天性异常。
