超声监测单绒毛膜囊双羊膜囊双胎脐带胎盘附着预测胎儿预后的价值  

Value of discordant cords in prognosis of monochronic diamniotic twins with ultrasonography

作　　者：甘晗靖[1,2] 王慧芳 林琪[1,2] 焦阳[1,2] 刘涛 熊奕[1,2] 张辉 

机构地区：[1]暨南大学第二临床医学院 [2]深圳市人民医院超声科,广东深圳518020 [3]深圳大学第一附属医院 [4]深圳市第二人民医院超声科,广东深圳518035

出　　处：《中国医学影像技术》2012年第6期1170-1173,共4页Chinese Journal of Medical Imaging Technology

基　　金：深圳市科技计划项目(200901004)

摘　　要：目的探讨产前超声监测单绒毛膜囊双羊膜囊(MCDA)双胎脐带胎盘附着预测妊娠结局的临床应用价值。方法回顾性分析127名MCDA双胎妊娠孕妇的产前超声检查结果和产后临床资料,比较两胎儿脐带胎盘附着一致组(59名)和不一致组(68名)的复杂性双胎发生率。结果脐带胎盘附着不一致组复杂性双胎的发生率为51.47%(35/68),脐带胎盘附着一致组为23.73%(14/59),差异有统计学意义(P<0.05);其中双胎之一脐带帆状附着的复杂性双胎发生率为59.09%(13/22),双胎之一脐带边缘附着的复杂性双胎发生率为47.83%(22/46),差异无统计学意义(P=0.444);双胎之一帆状附着中双胎输血综合征(TTTS)的发生率为40.91%(9/22),双胎之一边缘附着中TTTS的发生率为13.04%(6/46),差异有统计学意义(P<0.05)。结论产前超声监测MCDA双胎脐带胎盘附着能预测胎儿预后。Objective To observe the value of discordant cord insertions in prognosis of monochronic diamniotic （MCDA） twins with ultrasonography. Methods Totally 127 MCDA twins underwent fetal ultrasound screening were analyzed retrospectively. The incidences of complicated twins were compared between 59 cordant cords twins and 68 discordant cords twins. Results Discordant cords twins had higher incidence of complicated twins than cordant cords twins （51.47% [35/ 68] vs 23. 73% [14/59], P〈0. 05）. There was no statistical different between velamentous cord insertions in one of twin and marginal cord insertion in one of twin （59.09% [13/22] vs 47.83% [22/46], P=0.444）. Velamentous cord insertions twins had more twin-to-twin transfusion syndrome （TTTS） than marginal cord insertion twins （40.91 % [9/22] vs 13.04% [6/46], P〈0.05）. Conclusion Prenatal screening of cord insertions will be a key of prognosis in MCDA twins.

关 键 词：超声检查 产前 单绒毛膜囊双羊膜囊双胎 帆状附着 边缘附着 复杂性双胎 

分 类 号：R714.53[医药卫生—妇产科学] R455.1[医药卫生—临床医学]