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预测单胞胎双胞胎怀孕不良后果的预测因选择性胎儿生长限制而复杂

Shelly Soni^1,2, Juliana Gebb^1,2, Kendra Miller¹

¹Richard D. Wood Jr Center for Fetal Diagnosis and Treatment, Department of General, Thoracic and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Fetal diagnosis and therapy

|February 18, 2024

概括

在具有选择性胎儿生长限制 (sFGR) 的单胆双胞胎 (MCDA) 怀孕中,确定了不良结果的预测因素. 复杂的病例显示出更高的不一致性和更低的生存率,强调了高风险怀孕早期干预的必要性.

科学领域:

周围生理学周围生理学
孕产妇和胎儿医学孕产妇和胎儿医学
双胞胎怀孕双胞胎怀孕

背景情况:

在单胆双胞胎 (MCDA) 怀孕中,选择性胎儿生长限制 (sFGR) 提出了独特的挑战.
预测不良结果对于及时干预和改善新生儿存活率至关重要.

研究的目的:

为了确定MCDA双胞胎与sFGR.的贫困周产期结果的预测因素.
评估特定的胎儿变量和相互交织的EFW不一致性在预测生存中的作用.

主要方法:

预期管理的sFGR的MCDA双胞胎的回顾性分析 (2010-2021年).
根据羊水液,膀循环,静脉管 (DV) 流量和中脑动脉最大抽缩速度 (MCA-PSV) 将sFGR病例分类为简单或复杂.

主要成果:

复杂的sFGR病例表现出更高的交织EFW不一致性 (33%对26%) 和早期分娩 (30.5对33周).
在复杂病例中 (p < 0.0001),特别是I型复杂病例中 (70%与97.1%相比),存活到出院的时间明显较低.
增加的"复杂"得分和相互交织的EFW不一致性与两名幸存者的出院概率负相关 (AUC = 0.79).

结论:

橄水,缺少膀循环,异常的DV多普勒和升高的MCA-PSV与sFGR的不良周产期结局有关.
与这些临床变量相结合时,相互交织的EFW不一致性提高了生存结果的可预测性.

关键词:

复杂的选择性胎儿生长限制单胆子双胞胎是单胆子双胞胎.围产期结局的结果选择性的胎儿生长限制简单的选择性胎儿生长限制选择性胎儿生长限制的类型带动脉多普勒检测结果

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