单绒毛膜单羊膜囊双胎之一无脑畸形一例  

Monochorionic monoamniotic twins discordant for anencephaly: a case report

作　　者：钟燕秋 刘新秀[1] 陈敏[2] 李海英[1] 辜秋阳[1] 韦娟冰[3] 陈玲[1] 甘玲[1] Zhong Yanqiu;Liu Xinxiu;Chen Min;Li Haiying;Gu Qiuyang;Wei Juanbing;Chen Ling;Gan Ling(Department of Ultrasound, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China;Department of Prenatal Diagnosis and Fetal Medicine, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China;Department of Obstetrics and Gynecology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China)

机构地区：[1]福建医科大学附属第一医院超声影像科,福州350005 [2]广州医科大学附属第三医院产前诊断和胎儿医学科,510150 [3]福建医科大学附属第一医院妇产科,福州350005

出　　处：《中华围产医学杂志》2019年第5期345-349,共5页Chinese Journal of Perinatal Medicine

基　　金：福建省科技厅引导性项目(2016Y0038).

摘　　要：本文报道了1例中孕期于福建医科大学附属第一医院行超声检查诊断为单绒毛膜单羊膜囊双胎之一无脑畸形(monochorionic monoamniotic twin discordant for anencephaly, MCMATDA)的病例。孕7周于本院行彩超检查仅见宫内一孕囊回声及其内胚芽回声。孕12周于外院超声检查示宫腔中上段见一孕囊及一胎儿(头臀长约6.11 cm),胎儿颈项透明层厚度约0.11 cm。孕22周+6本院超声检查示宫腔内2个胎儿和1个胎盘回声,两胎儿之间未见明显隔膜回声;一胎儿结构未见明显异常,而另一胎儿头端圆形颅骨环及脑组织回声缺失,双眼球突出呈"蛙眼征"。建议患者转至具有宫内治疗技术的医院行减胎术治疗。孕23周+4外院超声引导下对无脑畸形胎儿行射频消融减胎术,手术顺利。孕35周孕妇胎膜早破并阴道分娩一男婴及一无脑畸形死胎。存活男婴随访至出生后4个月,健康状况良好。We reported a case of monochorionic monoamniotic twins discordant for anencephaly diagnosed by second-trimester ultrasonography at the First Affiliated Hospital of Fujian Medical University. Ultrasound at seven weeks of gestation showed only one gestational sac with an embryo inside. Another 12 gestational weeks' ultrasound scan performed at another hospital found one gestational sac and one fetus (crown-rump length was 6.11 cm and nuchal translucency was 0.11 cm) in the upper-middle uterine cavity. The ultrasound examination at 22^+6 gestational weeks identified one placenta and two fetuses without obvious diaphragm echo in between. Although no structural abnormality was observed in one fetus, frog-like eyes, absence of skull image and brain tissue echo were presented in the other fetus. The patient was transferred to a higher level hospital and was successfully performed radiofrequency ablation for selective reduction at 23^+4 weeks of gestation. At 35 weeks, a premature live boy and an anencephalic stillbirth fetus were born vaginally after premature rupture of membranes. The baby boy was healthy at follow-up at four months old.

关 键 词：无脑畸形 双生 单卵 超声检查 产前 妊娠减少 多胎 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]