单绒毛膜双羊膜囊双胎选择性宫内生长受限围生儿死亡31例高危因素分析  

Prenatal ultrasound monitoring in monochorionic diamniotic twin with selective intrauterine growth restriction

作　　者：林莉[1,2] 孙秀荣[1,2] 刘涛[1,3] 

机构地区：[1]暨南大学第二临床医学院 [2]广东省深圳市人民医院产科,广东深圳518020 [3]广东省深圳市人民医院超声科,广东深圳518020

出　　处：《中国实用妇科与产科杂志》2012年第12期945-947,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨超声下单绒毛膜双羊膜囊双胎选择性宫内生长受限围生儿死亡高危因素。方法选择2010年3月至2012年2月在暨南大学第二临床医学院产科分娩的31例单绒毛膜双羊膜囊双胎选择性宫内生长受限孕妇,定期采用超声检查进行胎儿体重估测以及羊水测定,并根据脐动脉舒张期血流频谱分为Ⅰ型、Ⅱ型及Ⅲ型,研究各超声指标与围生儿死亡的关系。结果Ⅱ型围生儿病死率明显高于Ⅰ型,差异有统计学意义(P<0.05);出现重度宫内生长受限者其围生儿病死率明显高于无重度宫内生长受限者(P<0.01);羊水过少组与非羊水过少组比较,围生儿病死率差异有统计学意义(P<0.05)。结论Ⅱ型和出现重度宫内生长受限是单绒毛膜双羊膜囊双胎选择性宫内生长受限围生儿死亡的高危因素。Objective To investigate the clinical significance of prenatal ultrasound parameters in predicting perinatal death in monochorionic diamniotic （MCDA） twin with selective intrauterine growth restriction （slUGR）. Methods 31 cases of MCDA twins with sIUGR who delivered between March 2010 and February 2012 in our hospital were recruited for the study. Cases were categorized in to sIUGR type I , II and III according to the different Doppler patterns of end diastolic flow velocity （EDFV） of the umbilical artery. After diagnosing sIUGR, fetal growth, amniotic fluid, and the EDFV were monitored with ultrasound and Doppler for each case. Results The perinatal death rate was significantly higher in cases with type II Doppler pattern compared with cases with type I pattern （ P 〈 0. 05 ） , and was significantly higher in cases with severe IUGR than eases without （P 〈 0. 01 ）. Compared with eases with normal amniotic fluid, cases with oligohydramnios had significantly higher perinatal death （ P 〈 0. 05 ）. Conclusion Type lI Doppler pattern of the umbilical artery and sever IUGR are the risk factors of perinatal death in MCDA cases with sIUGR.

关 键 词：超声多普勒 单绒毛膜双羊膜囊双胎 选择性宫内生长受限 围生儿死亡 

分 类 号：R714.23[医药卫生—妇产科学]