Sebire N J, D'Ercole C, Hughes K, Carvalho M, Nicolaides K H
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School, London, UK.
Ultrasound Obstet Gynecol. 1997 Aug;10(2):86-9. doi: 10.1046/j.1469-0705.1997.10020086.x.
The study examines a possible association between increased nuchal translucency thickness at 10-14 weeks of gestation in monochorionic twin pregnancies and the subsequent development of severe twin-to-twin transfusion syndrome (TTS). In 132 monochorionic twin pregnancies, including 16 that developed severe TTS at 15-22 weeks of gestation and 116 that did not develop TTS, crown-rump length, nuchal translucency thickness and fetal heart rate were measured at 10-14 weeks. In those that developed severe TTS, the prevalence of nuchal translucency thickness above the 95th centile of the normal range and the intertwin difference in nuchal translucency thickness and fetal heart rate were significantly higher than in the non-TTS group; there were no significant differences between the groups in the inter-twin difference in crown-rump length. For fetal nuchal translucency above the 95th centile, the positive and negative predictive values for the development of TTS were 38% and 91%, respectively; the likelihood ratios of nuchal translucency above or below the 95th centile for the development of severe TTS were 4.4 (1.8-9.7) and 0.7 (0.4-0.9), respectively. These findings demonstrate that the underlying hemodynamic changes associated with TTS may manifest as increased fetal nuchal translucency thickness at 10-14 weeks of gestation.
该研究调查了单绒毛膜双胎妊娠孕10 - 14周时颈部半透明层厚度增加与随后发生严重双胎输血综合征（TTS）之间的可能关联。在132例单绒毛膜双胎妊娠中，包括16例在孕15 - 22周发生严重TTS的病例和116例未发生TTS的病例，于孕10 - 14周测量了顶臀长、颈部半透明层厚度和胎儿心率。在发生严重TTS的病例中，颈部半透明层厚度高于正常范围第95百分位数的患病率以及双胎之间颈部半透明层厚度和胎儿心率的差异显著高于非TTS组；两组之间双胎顶臀长的差异无显著意义。对于胎儿颈部半透明层厚度高于第95百分位数的情况，TTS发生的阳性预测值和阴性预测值分别为38%和91%；颈部半透明层厚度高于或低于第95百分位数时发生严重TTS的似然比分别为4.4（1.8 - 9.7）和0.7（0.4 - 0.9）。这些发现表明，与TTS相关的潜在血流动力学变化可能表现为孕10 - 14周时胎儿颈部半透明层厚度增加。
