Prospective study of the MD-twin score for antepartum evaluation of monochorionic diamniotic twins and its correlation with peinatal outcomes
Prospective study of the MD-twin score for antepartum evaluation of monochorionic diamniotic twins and its correlation with peinatal outcomes
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MD-twin评分对单绒毛膜双羊膜双胞胎产前评估及其与产前结局的相关性的前瞻性研究
DOI：
10.1111/jog.12258
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
T Ikenoue
中科院分区：
文献类型：
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作者：
M Oohashi;M Kaneko;H Sameshima;Y Kodama;T Ikenoue
目的 借助 MD-双胞胎评分来评估单绒毛膜双羊膜 (MD) 双胞胎的结局。方法我们于 1997 年至 2009 年间在三级围产期中心招募了 112 名 MD-双胞胎女性。MD-双胞胎评分前瞻性地每周应用于 26 周后没有出现双胎输血综合征 (TTTS) 的女性。 妊娠。 MD-twin 评分由五个变量组成：(i) 胎儿体重不一致； (ii) 羊水不一致； (iii) 胎儿水肿； (iv) 脐带插入； (v) 胎心率监测。正常记0分，异常记1分，采用总分进行评价。妊娠 26 周时评分为 2 的女性接受预期治疗，直至评分达到 3。结果指标为胎儿死亡、新生儿死亡和神经系统后遗症。根据评分调查不良结果的发生率。对预后不良的 MD 双胞胎的特征进行了调查。结果 MD 双胞胎评分适用于 90 名女性。其中，得分在2分以下的有79人，均取得良好成绩。有 11 名女性得分为 3，其中 4 名女性至少有一个双胞胎的结局不佳。无论出生体重百分位数如何，得分为 0-2 的女性所生的新生儿结局良好，而得分为 3 的新生儿，当出生体重百分位数低于第三个百分位数时，结局较差。结论 MD-双胞胎评分适用于 90% 没有 TTTS 的 MD 双胞胎。 MD-twin 评分为 2 分令人放心，而评分为 3 则表明不良结果的风险增加。
AimTo assess the outcome of monochorionic diamniotic (MD) twins with the aid of the MD‐twin score.MethodsWe enrolled 112 MD‐twin women in a tertiary perinatal center from 1997 to 2009. The MD‐twin score was prospectively applied once per week to women who did not have twin‐to‐twin transfusion syndrome (TTTS) after 26 weeks of gestation. The MD‐twin score consists of five variables: (i) fetal weight discordance; (ii) amniotic fluid discordance; (iii) hydrops fetalis; (iv) umbilical cord insertion; and (v) fetal heart rate monitoring. Normal was assigned a value of 0, abnormal was assigned 1, and total score was used for evaluation. Women with scores of 2 at 26 weeks gestation were managed expectantly until the score reached 3. Outcome measures were fetal death, neonatal death and neurological sequelae. The incidence of poor outcome according to score was investigated. The characteristics of MD twins with poor outcome were investigated.ResultsMD‐twin scores were applied to 90 women. Among them, 79 had scores of 2 or less and all had good outcomes. There were 11 women with a score of 3, four of whom had adverse outcome for at least one twin. Neonates born to women with scores of 0–2 had good outcomes without respect to birthweight percentile, while neonates with scores of 3 had poor outcomes when their birthweight percentile was less than the third percentile.ConclusionThe MD‐twin score is applicable to 90% of MD twins without TTTS. An MD‐twin score of 2 is reassuring, while a score of 3 indicates increased risks for adverse outcome.