Chou Y H, Tsou Yau K I, Wang P J, Shen Y Z, Lee C Y
Department of Pediatrics, National Taiwan University Hospital, Taipei, R.O.C.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1993 Nov-Dec;34(6):474-9.
From a recent monochorionic diamniotic twin pregnancy seen at this hospital, one of the twins died in utero at 37 weeks' gestation. The other twin, a male infant, was delivered by Cesarean section because of fetal distress, with resuscitation performed in the delivery room. The infant developed generalized tonic seizure shortly after stabilization, and was put on anticonvulsants. The initial brain echography was normal; follow-up echograms and CT scans performed at 8 and 12 days old, respectively, revealed diffuse low density over both side of cerebral hemisphere. At one month old, the infants's brain echogram showed diffuse cystic encephalomalacia. At four months, he was noted to be spastic and significantly delayed in neurodevelopment. Disseminated intravascular coagulation caused by fetal-to-fetal transfer of thromboplastic material from the dead fetus was considered as the most possible cause of the neurological complication in this patient. In addition, perinatal hypoxic-ischemic insult may also have been a superimposed, influencing factor.
在本院近期接诊的一例单绒毛膜双羊膜囊双胎妊娠中，其中一个胎儿在孕37周时死于宫内。另一个胎儿为男婴，因胎儿窘迫行剖宫产分娩，在产房进行了复苏。婴儿在情况稳定后不久出现全身性强直发作，并开始使用抗惊厥药物。最初的脑部超声检查正常；分别在出生8天和12天时进行的超声复查和CT扫描显示双侧大脑半球弥漫性低密度影。1个月大时，婴儿的脑部超声显示弥漫性囊性脑软化。4个月时，发现他有痉挛症状，神经发育明显延迟。由死胎向存活胎儿转移促凝物质导致的弥散性血管内凝血被认为是该患者神经并发症最可能的原因。此外，围产期缺氧缺血性损伤也可能是一个叠加的影响因素。
