单绒毛膜性双胎脐带附着位置与双胎输血综合征、双胎生长不一致及胎儿结构畸形的相关性研究

发布时间：2018-01-25 16:58

  本文关键词： 单绒毛膜性双胎 脐带附着位置 双胎输血综合症 生长不一致 胎儿结构畸形　出处：《东南大学学报(医学版)》2017年04期 　论文类型：期刊论文

【摘要】：目的:探讨单绒毛膜性双胎脐带附着位置与双胎输血综合征(TTTS)、双胎生长不一致及胎儿结构畸形的相关性。方法:自2010年10月至2016年10月行中晚孕超声检查单绒毛膜性胎儿共58例,每例胎儿均多切面扫查脐带附着位置,回顾性分析脐带附着位置异常双胎中TTTS、胎儿生长不一致及胎儿结构畸形的发生率。结果:58例单绒毛膜性双胎中双胎之一脐带为边缘性或帆状附着胎盘者共9例,均出现不同程度TTTS。双胎之一脐带附着位置近胎盘边缘13例,其中8例出现胎儿生长不一致,另5例胎儿生长发育参数无明显差异。胎儿严重结构异常4例,轻度结构异常10例,结构异常胎儿中仅1例胎儿脐带边缘附着。结论:单绒毛膜性双胎之一脐带附着位置为边缘性或帆状附着与TTTS有明确相关性;脐带附着近胎盘边缘与胎儿生长不一致的发生有一定关系,但不是决定性因素;脐带附着位置异常与胎儿畸形无明确相关性。
[Abstract]:Objective: to investigate the position of umbilical cord attachment and TTS in single chorionic twins. Methods: from October 2010 to October 2016, 58 cases of single chorionic fetus were examined by ultrasound from October 2010 to October 2016. The location of umbilical cord attachment was examined by multi-sectional scanning in each fetus. The TTTS in the twins with abnormal umbilical cord attachment was analyzed retrospectively. Results 9 of 58 single chorionic twins with marginal or sail placenta attached to one of the twin chorionic twins. There were 13 cases of umbilical cord attachment near the placenta edge, 8 of which showed fetal growth inconsistency. All of them had different degrees of TTTS.There were 13 cases of umbilical cord attachment near the edge of placenta. There was no significant difference in the parameters of fetal growth and development in the other 5 cases. There were severe structural abnormalities in 4 cases and mild structural abnormalities in 10 cases. Only one fetus with abnormal structure attached to the edge of umbilical cord. Conclusion: the location of umbilical cord attachment in single chorionic twins is marginal or sails, and there is a clear correlation between umbilical cord attachment and TTTS. There is a certain relationship between umbilical cord attachment near the placental edge and the occurrence of fetal growth inconsistency, but it is not a decisive factor. There was no clear correlation between abnormal attachment of umbilical cord and fetal malformation.
【作者单位】： 中国人民解放军第一五三中心医院超声科;中国人民解放军第一五三中心医院妇产科;郑州大学第一附属医院超声科;
【分类号】：R445.1;R714.5
【正文快照】： 近年来,随着人口出生率的增加,各种人工辅助生殖技术的应用,双胎妊娠率不断上升。双胎妊娠的风险较单胎妊娠风险大,特别是单绒毛膜性(MC)双胎。MC双胎在所有妊娠中的发病率为1/400,属于高危妊娠,胎儿丢失率及围产期病死率较高[1]。双胎输血综合征(TTTS)是MC双胎的严重并发症,，

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