Trespidi L, Boschetto C, Caravelli E, Villa L, Kustermann A, Nicolini U
1st Department of Obstetrics and Gynecology, University of Milan, Italy.
Fetal Diagn Ther. 1997 Jan-Feb;12(1):15-20.
Serial decompressive amniocenteses were performed at 18-23 weeks of gestation in 23 pregnancies referred due to echographic signs typical of twin-twin transfusion syndrome. The procedures were repeated until delivery or permanent normalization of the amniotic fluid volume both in the donor and the recipient twin sac. The overall survival rate was 57%, but in only 39% of the pregnancies did both twins survive without handicaps. The absence of end diastolic flow in the umbilical artery of the donor twin was associated with poor chances of survival for both fetuses; in contrast, the presence of hydrops or ascites in the recipient twin did not worsen the prognosis. A policy of aggressive amniotic fluid decompression may achieve permanent resolution of the fluid in over 50% of the pregnancies complicated by twin-twin transfusion syndrome.
对23例因双胎输血综合征典型超声征象而转诊的妊娠患者，在妊娠18 - 23周时进行了系列减压羊膜穿刺术。重复进行该操作，直到分娩或供体和受体双胎羊膜囊内羊水量永久正常化。总体存活率为57%，但只有39%的妊娠中两个胎儿均存活且无残疾。供体双胎脐动脉舒张末期血流消失与两个胎儿的存活机会不佳相关；相反，受体双胎出现水肿或腹水并未使预后恶化。积极的羊水减压策略可能使超过50%合并双胎输血综合征的妊娠中羊水问题得到永久解决。
