Doppler demonstration of reversed umbilical blood flow in an acardiac twin.
Doppler demonstration of reversed umbilical blood flow in an acardiac twin.
复制标题
多普勒显示无心双胞胎脐血流逆转。
DOI：
10.1002/jcu.1870170412
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发表时间：
1989
期刊：
影响因子：
--
通讯作者：
Doubilet,PM
中科院分区：
文献类型：
--
作者：
Benson,CB;Bieber,FR;Genest,DR;Doubilet,PM
心动过速是一种罕见的异常，是单绒毛膜双胞胎所特有的。这种奇怪的发育异常包括各种各样的畸形，通常包括胸部和腹部许多器官的缺失，典型的是缺乏功能的心脏(因此被称为“阿卡迪亚”)。已经提出，这种异常的发生是由于双胎胎盘广泛的动脉与动脉和静脉与静脉的吻合，导致异常的双胞胎(灌注型无心双胞胎)从双胞胎(泵双胎)中灌流而来。这将需要异常双胞胎的脐动脉反向流动：通过脐动脉流入，通过脐动脉流出。这一观点得到了对无心双胞胎胎盘的仔细检查的支持，但还没有活体证据证明反向血流。我们研究了一对无心双胞胎，用多普勒超声记录了宫内脐动脉和静脉的血流方向。我们的结果提供了直接证据，证明无心畸形发生动脉反向灌注，并支持其在这些不寻常的双胞胎中所见异常的发病机制中可能起的作用。
Acardia is a rare anomaly that is unique to monochorionic twins. This bizarre developmental anomaly consists of a wide spectrum of malformations, usually including absence of many organs in the thorax and abdomen, typically with lack of a functional heart (hence the term “acardia”). It has been proposed that the anomaly develops as a result of extensive artery-to-artery and vein-to-vein anastomoses in the twin placenta leading to perfusion of the abnormal twin (the perfused acardiac twin) from the cotwin (the pump twin). This would entail reversed flow in the umbilical vessels of the anomalous twin: inflow via the umbilical artery or arteries, outflow via the umbilical This idea is supported by careful examination of placentas from acardiac twins, but in vivo demonstration of the reversed blood flow has been unavailable. We studied an acardiac twin using Doppler sonography to document the direction of umbilical arterial and venous flow in utero. Our results provide direct evidence that reversed arterial perfusion occurs in acardia and support its possible role in the pathogenesis of the anomalies seen in these unusual twins.