Twin chorionicity and the risk of adverse perinatal outcome
Twin chorionicity and the risk of adverse perinatal outcome
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DOI：
10.1016/j.ijgo.2006.11.002
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发表时间：
2007-02-01
影响因子：
3.8
通讯作者：
Gratacos, E.
中科院分区：
文献类型：
--
作者：
Acosta-Rojas, R.;Becker, J.;Gratacos, E.
目的：评估绒毛膜性对双胎妊娠并发双胎输血综合征（TTS）或选择性宫内生长受限（sIUGR）围产期结局的影响。方法：对 127 例单绒毛膜 (MC) 和 109 例双绒毛膜 (DC) 双胞胎的妊娠进行随访，评估 TTS 和 sIUGR 发生率以及发病率和死亡率。结果：MC 妊娠的宫内胎儿死亡发生率高于 DC 妊娠（6.5% vs. 1%），且合并 TTS（10 次妊娠中有 5 例死亡 [50%]）或 sIUGR（9 例妊娠中有 2 例死亡 [22%]）的 MC 妊娠发生率更高。 MC 和 DC 妊娠中 sIUGR 的发生率相似（7% vs. 5%），MC 妊娠中 TTS 的发生率为 8%（95% 置信区间，3.2-12.8）。 MC 双胞胎的新生儿神经和呼吸系统发病率较高，新生儿并发症的增加与 TTS 和 sIUGR 相关。无并发症的 MC 和 DC 妊娠具有相似的围产期结局。结论：妊娠合并TTS或sIUGR的MC双胞胎新生儿并发症发生率较高。尽管 MC 和 DC 妊娠中 sIUGR 的发生率相似，但受 sIUGR 影响的 MC 妊娠有结局更差的趋势。 (c) 2006 年国际妇产科联合会。由爱思唯尔爱尔兰有限公司出版。保留所有权利。
Objective: To evaluate the impact of chorionicity on the perinatal outcomes of twin pregnancies complicated by twin-twin transfusion syndrome (TTS) or selective intrauterine growth restriction (sIUGR). Method: Pregnancies with 127 monochorionic (MC) and 109 dichorionic (DC) twins were followed up, and TTS and sIUGR incidence as welt as morbidity and mortality were evaluated. Results: The incidence of intrauterine fetal death was higher in MC than in DC pregnancies (6.5% vs. 1%), and higher in MC pregnancies complicated by TTS (5 deaths in 10 pregnancies [50%]) or sIUGR (2 in 9 [22%]). The incidence of sIUGR was similar in MC and DC pregnancies (7% vs. 5%), and the incidence of TTS was 8% in MC pregnancies (95% confidence inter-vat, 3.2-12.8). Neonatal neurological and respiratory morbidity was higher among MC twins, and the increase in neonatal complications was linked to TTS and sIUGR. Uncomplicated MC and DC pregnancies had similar perinatal, outcomes. Conclusion: The incidence of neonatal complications was higher in MC twins born of pregnancies complicated by TTS or sIUGR. Although the incidence of sIUGR was similar in MC and DC pregnancies, there was a trend towards worse outcomes in MC pregnancies affected by sIUGR. (c) 2006 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.