Twin embolization syndrome: prenatal sonographic detection and significance.
Twin embolization syndrome: prenatal sonographic detection and significance.
复制标题
双胎栓塞综合征：产前超声检查及其意义。
DOI：
10.1148/radiology.173.3.2682772
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发表时间：
1989
期刊：
影响因子：
19.7
通讯作者：
R. Filly
中科院分区：
文献类型：
--
作者：
R. Patten;L. Mack;D. Nyberg;R. Filly
双胞胎栓塞综合征（TES）是同卵双胞胎在子宫内死亡后的并发症。血栓形成物质进入存活双胞胎的循环导致中枢神经系统、胃肠道和泌尿生殖系统的缺血性结构缺陷。在6例这种罕见异常的病例中，超声检查正常的胎儿随后表现出脑室扩大，脑穿通，脑萎缩，或在双胞胎死亡后小头畸形。颅外异常包括小肠闭锁（2例）和肾皮质坏死（1例）。存活的双胞胎在随访时都有神经发育迟缓。两个胎儿流产，因为超声明显，进行性严重的脑异常。一个双卵三胞胎妊娠的唯一幸存者是正常的，尽管超声检查结果的TES在co-triplets。由于预后差，产前超声诊断TES可能会影响产前或新生儿管理的幸存的单合子双胞胎。认识到TES可能允许准确的产后咨询的预后和复发风险。
Twin embolization syndrome (TES) is a complication of monozygotic twinning following in utero demise of the co-twin. Passage of thromboplastic material into the circulation of the surviving twin results in ischemic structural defects of the central nervous system, gastrointestinal tract, and genitourinary system. In six cases of this rare abnormality, sonographically normal fetuses subsequently demonstrated ventriculomegaly, porencephaly, cerebral atrophy, or microcephaly following demise of the co-twin. Extracranial abnormalities included small bowel atresia (two cases) and renal cortical necrosis (one case). Surviving twins all had neurodevelopmental delay at follow-up. Two fetuses were aborted because of sonographically apparent, progressively severe brain abnormality. The lone survivor of a dizygotic triplet gestation was normal, despite sonographic findings of TES in the co-triplets. Because of poor outcome, prenatal sonographic diagnosis of TES may influence antenatal or neonatal management of the surviving monozygous twin. Recognition of TES may permit accurate postnatal counseling of prognosis and recurrence risks.