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在单胆子双胞胎中选择性宫外胎盘输液是可行的-一个案例系列

Benjamin Kuehne¹, Jan Trieschmann¹, Sarina Kim Butzer¹

¹Division of Neonatology, Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.

Children (Basel, Switzerland)

|October 26, 2024

概括

选择性宫外胎盘输液 (EPP) 与延迟的带紧 (DCC) 在单双胞胎的捐赠婴儿可能会预防严重贫血和多细胞血症,改善双胞胎贫血-多细胞血症序列 (TAPS) 和双胞胎对双胞胎输血综合征 (TTTS) 的结果.

科学领域:

新生儿复苏术新生儿复苏术
周围生理学周围生理学
孕产妇与胎儿的医学

背景情况:

双胞胎 (MC) 双胞胎面临双胞胎对双胞胎输血综合征 (TTTS) 和双胞胎贫血多细胞血症序列 (TAPS) 的风险.
在早产的MC双胞胎中,即时的带紧 (ICC) 可能会使供体贫血和受体多细胞血症恶化.
目前的做法可能会增加受影响的捐赠婴儿的发病率.

研究的目的:

评估选择性宫外胎盘输液 (EPP) 与延迟带紧 (DCC) 在捐赠婴儿的可行性.
证明EPP和DCC在预防捐赠双胞胎严重贫血方面的潜力.
为了评估接受双胞胎的多细胞血症的预防.

主要方法:

用DCC选择性EPP应用于怀疑患有严重供体贫血的早产MC双胞胎 (<1500g) 的供体婴儿.
捐赠者的带在DCC中保持完整,而接受者的带经历了ICC.
在手术过程中,婴儿接受呼吸辅助.

主要成果:

在三例患有TAPS和急性周周TTTS的MC双胞胎中,选择性EPP成功执行.
所有捐赠双胞胎的初始血红蛋白水平保持在≥13.0g/dL.
没有任何捐赠双胞胎在出生后的第一天需要红细胞输血.

结论:

选择性EPP与DCC似乎是一个可行的策略,用于早产MC双胞胎的新生儿复苏.
这种方法可以有效地预防捐赠婴儿的贫血相关疾病.
该技术有望改善复杂双胞胎怀孕中的婴儿结果.

关键词:

延迟的绳索紧时间双胞胎是单体双胞胎.基于生理学的绳索紧方式双胞胎贫血-多细胞贫血序列双胞胎对双胞胎输血综合征非常低的出生体重婴儿婴儿

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