双胞胎妊娠与选择性胎儿生长限制:多普勒异常的预后,并发症和影响
概括
双 (DC) 双胞胎的选择性胎儿生长限制 (sFGR) 显著增加了不良围产期结果的风险,包括死亡和新生儿发病率. 异常多普勒研究进一步提高了这些风险,支持量身定制的管理策略.
科学领域:
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 周围生理学 周围生理学
- 产科 产科 产科 产科 产科
背景情况:
- 选择性胎儿生长限制 (sFGR) 复杂化双胞胎 (DC) 怀孕,对两个胎儿构成风险.
- 多普勒异常在sFGR中很常见,可能表明疾病进展和不良结果.
研究的目的:
- 为了评估DC双胞胎怀孕与sFGR的孕产妇和产周结果.
- 调查多普勒异常与这些怀孕中不良结果的发生,进展和关联.
主要方法:
- 对DC双胞胎怀孕在2011-2023年间分娩的回顾性研究.
- 根据Delphi标准定义的sFGR;与sFGR和没有sFGR的怀孕之间结果的比较,早期与晚期的sFGR,以及多普勒异常的存在/不存在 (UA,MCA).
主要成果:
- sFGR (11.1%的病例) 与子宫内死亡,围产期死亡,综合新生儿发病率,新生儿重症监护室入院和子宫前的风险显著增加有关.
- 早期的sFGR与新生儿发病率增加和多普勒异常相关.
- 动脉 (UA) 多普勒异常增加了子宫内死亡,围产期死亡和新生儿发病率的风险.
结论:
- 双胞胎DC怀孕的sFGR,特别是多普勒异常发现,面临着不良周产期结果的高风险.
- 在DC双胞胎中,sFGR的管理应与单独怀孕的指导方针保持一致.
- 监测多普勒指数的进展对于及时干预至关重要.
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