Discordant Blood Chimerism in Dizygotic Monochorionic Laser-Treated Twin-Twin Transfusion Syndrome
Discordant Blood Chimerism in Dizygotic Monochorionic Laser-Treated Twin-Twin Transfusion Syndrome
复制标题
DOI：
10.1097/aog.0b013e3181e4bec7
复制
发表时间：
2010-08-01
影响因子：
7.2
通讯作者：
Chmait, Ramen H.
中科院分区：
文献类型：
--
作者：
Assaf, Samer A.;Randolph, Linda M.;Chmait, Ramen H.
背景：双胞胎输血综合征发生在10%的单卵单绒毛膜双胞胎妊娠中，是由于供者通过胎盘吻合口与受者胎儿的血液交换不平衡所致。基因分析显示，双胞胎在出生时和6个月时都存在46，XX/46，XY血液学嵌合体，受者双胞胎的嵌合体明显高于供者。胎盘病理检查证实所有吻合口均为单层绒毛膜和激光消融。结论：尽管胎儿循环在宫内分离远离分娩，但血液学嵌合体在出生后仍然存在。我们推测，与供者相比，受者的血液嵌合程度更高，这与激光手术前双胞胎输血综合征的病理生理学有关。(Obstet妇科2010；116：483-5)
BACKGROUND: Twin-twin transfusion syndrome occurs in 10% of monozygotic monochorionic twin gestations and results from an unbalanced exchange of blood from the donor to the recipient fetus through placental anastomoses.CASE: We present a case of twin-twin transfusion syndrome with differing fetal sex treated with in utero laser surgery. Genetic analyses showed 46,XX/46,XY hematologic chimerism in both twins at birth and at 6 months, with the recipient twin being significantly more chimeric than the donor. Placental pathologic examination confirmed monochorionicity and laser ablation of all anastomoses.CONCLUSION: Despite in utero separation of the fetal circulations remote from delivery, hematologic chimerism persisted after birth. We speculate that the greater degree of blood chimerism in the recipient compared with the donor was related to the pathophysiology of twin-twin transfusion syndrome before laser surgery. (Obstet Gynecol 2010;116:483-5)