双胞胎贫血多细胞血症序列中的单个胎儿死亡:幸存的双胞胎胎的围产期结局
M J A van de Sande1, E Lopriore2, M Lanna3
1Department of Obstetrics, Division of Fetal Therapy, Leiden University Medical Center, Leiden, The Netherlands.
概括
在双胞胎怀孕中,双胞胎贫血多细胞血症序列 (TAPS),单次子宫内胎儿死亡 (IUFD) 显示了幸存的双胞胎死亡和严重脑损伤的风险较低. 这种结果很可能是由于对胎盘连接的输血很少.
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
- 新生儿科学 新生儿科学
背景情况:
- 双胞胎贫血多细胞血症序列 (TAPS) 是单双胞胎的一种并发症.
- 在TAPS怀孕中,自发单次子宫内胎儿死亡 (IUFD) 可能发生.
- 评估单个IUFD对幸存的双胞胎的影响对于管理至关重要.
研究的目的:
- 为了评估TAPS复杂的单双双胞胎怀孕中自发单 IUFD 后幸存的双胞胎的围产结局.
主要方法:
- 来自国际TAPS注册表 (2014-2023) 的TAPS和单 IUFD单双双胞胎怀孕的回顾性分析.
- 主要结局:在幸存的双胞胎中死亡率和严重的新生儿脑损伤.
- 包括39个怀孕自发单 IUFD.
主要成果:
- 大多数TAPS病例发生在双胞胎输血综合征的激光手术后 (77%).
- 单 IUFD 主要发生在 23 周左右的捐赠双胞胎 (90%) 中.
- 幸存的双胞胎的死亡率很低 (3%),没有新生儿严重脑损伤或需要子宫内输血的病例.
结论:
- 在TAPS单胞胎怀孕中,自发单胞胎IUFD与幸存的双胞胎不良结果的风险较低有关.
- 通过小胎盘解剖体进行最小的死前输血可能解释了有利的结果.
- 这些发现支持仔细监测,而不是在特定情况下进行积极的干预.
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