周産期一卵性一羊膜双胎妊娠の周産期予後
Sofia Roero1, Silvana Arduino1, Agata Ingala1
19314 Gynaecology and Obstetrics 2U, Sant'Anna Hospital, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, University of Turin , Turin, Italy.
Journal of perinatal medicine
|January 27, 2026
まとめ
一絨毛膜一羊膜(MCMA)双胎妊娠では、妊娠24週以前の胎児死亡率が高い。これらのハイリスク妊娠では、34週以降の分娩延期により、周産期有害事象が減少する可能性がある。
科学分野:
- 周産期医学
- 母体胎児医学
- ハイリスク妊娠
背景:
- 一絨毛膜一羊膜(MCMA)双胎はまれであり、重大なリスクと関連しています。
- 胎児死亡および新生児予後の理解は、管理の最適化に不可欠です。
研究 の 目的:
- MCMA双胎妊娠における早期および晩期胎児死亡のリスクを決定すること。
- 周産期予後を記述し、新生児有害事象に影響を与える要因を特定すること。
主な方法:
- 53例のMCMA双胎妊娠(2005-2024年)の後ろ向きコホート研究。
- 妊娠初期における絨毛膜性と羊膜性の診断。
- 胎児および新生児の予後を評価するための分娩までの追跡調査。
主要な成果:
- 子宮内胎児死亡の全体的な発生率は23.6%でした。
- 妊娠24週以前の胎児死亡は19.8%で、24週以降は3.6%に減少しました。
- 生児のうち約25%に新生児有害事象が発生し、在胎週数、出生体重、奇形(発生率13.4%)の影響を受けました。
結論:
- MCMA双胎における胎児死亡の大部分は妊娠24週以前に発生します。
- 妊娠24週以降の胎児死亡率は低いです。
- 早産に関連するリスクを軽減するために、選択的分娩を34週以降に延期することを検討する可能性があります。
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