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胎儿-胎儿输血综合征的产前诊断与治疗

[Prenatal diagnosis and therapy of feto-fetal transfusion syndrome].

作者信息

Mielke G, Gonser M

机构信息

Universitäts-Frauenklinik Tübingen.

出版信息

Z Geburtshilfe Neonatol. 1998 Jul-Aug;202(4):141-8.

PMID:9783371
Abstract

Twin-twin transfusion syndrome (TTTS) is a serious complication of monochorionic twin pregnancies. It is the result of an unbalanced transfusion of blood across placental vascular anastomoses. TTTS appears predominantly in the second trimester of pregnancy characterized by discordance of growth as well as polyhydramnios in the recipient and oligo-/anhydramnios in the donor. Prenatal diagnosis is possible by non-invasive and invasive methods. The prognosis of the untreated TTTS is very poor. Serial amniocenteses and laser therapy are used resulting in survival rates of about 60%. Intrauterine death of one twin is associated with a high risk of morbidity in the surviving twin. Monochroionic twins have to be identified in early pregnancy. Close surveillance is necessary to diagnose TTTS at an early stage of the disease.

摘要

双胎输血综合征(TTTS)是单绒毛膜双胎妊娠的一种严重并发症。它是通过胎盘血管吻合处进行不均衡输血的结果。TTTS主要出现在妊娠中期,其特征为双胎生长不一致,受血儿羊水过多,供血儿羊水过少/无羊水。可通过非侵入性和侵入性方法进行产前诊断。未经治疗的TTTS预后很差。采用系列羊膜腔穿刺术和激光治疗,存活率约为60%。一个胎儿宫内死亡与存活胎儿的高发病风险相关。必须在妊娠早期识别单绒毛膜双胎。密切监测对于在疾病早期诊断TTTS很有必要。

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