单绒毛膜双羊膜囊双胎一胎畸形的临床咨询  

Clinical consultation for discordant structural malformations in monochorionic diamniotic twins

作　　者：杲丽[1] 王彦林[1] GAO Li;WANG Yan-lin(Division of Maternal-Fetal Fetal Medicine,Prenatal Diagnosis Center,The International Peace Maternity and Child Health Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院,上海市胚胎源性疾病重点实验室,上海200030

出　　处：《中国实用妇科与产科杂志》2025年第2期138-141,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家重点研发计划(2023YFC2705901)。

摘　　要：双胎妊娠中单绒毛膜双羊膜囊(MCDA)双胎的管理是围产医学中的难点。由于2个胎儿共用1个胎盘,当MCDA双胎中1个胎儿存在畸形时,临床咨询面临诸多挑战。对于此类复杂双胎,应转至有宫内治疗能力的胎儿医学中心进行咨询、随访及诊治,提供个体化的临床咨询及处理。处理方案应根据MCDA双胎之一畸形的类型、严重程度,以及是否会对另一个胎儿产生影响等进行制定。应遵循最大限度减少对健康胎儿和母体影响的原则,同时充分尊重父母的决定。制定个性化方案,实施从产前到分娩乃至新生儿阶段的序贯化、一体化管理模式。The management of monochorionicdiamniotic(MCDA) twins is a challenge inperinatal medicine. Since the two fetuses share asingle placenta,clinical consultation faces numerouschallenges when one of the MCDA twins hasdiscordant structural malformations. For suchcomplex twins,referral to a fetal medical center withintrauterine treatment capabilities is necessary forconsultation, follow-up and management.Individualized clinical counseling and managementshould be provided. The management plan should beformulated based on the type and severity of themalformations,as well as the impact on the otherfetus. The principle of minimizing the impact on thehealthy fetus and the mother should be followed;meanwhile the parents also be fully respected inmaking decisions. A personalized plan should bemade to implement a sequential and integratedmanagement model from the prenatal stage tothrough delivery and even to the neonatal period.

关 键 词：双胎妊娠 单绒毛膜 双胎一胎畸形 临床咨询 

分 类 号：R714.23[医药卫生—妇产科学]