诊断和自发双胞胎贫血多细胞血症序列的管理在早期的第二个三个月:一个案例报告
Fetal diagnosis and therapy
|January 13, 2026
概括
早期监测双胞胎贫血多细胞血症序列 (TAPS) 使用中脑动脉峰值缩速度多普勒,从怀孕16周开始,对于及时干预单胞胎怀孕至关重要. 这有助于管理严重病例并改善结果.
科学领域:
- 周围生理学 周围生理学
- 胎儿医学 胎儿医学
- 高风险的妇产科 高风险的妇产科
背景情况:
- 自发双胞胎贫血-多细胞血症序列 (TAPS) 影响3至5%的单胞胎怀孕.
- TAPS与显著的神经并发症和死亡率有关.
- 目前TAPS的监测协议已经讨论了最佳妊娠年龄的开始.
研究的目的:
- 突出早期中脑动脉 (MCA) 多普勒监测在检测自发TAPS时的重要性.
- 介绍一个早期III阶段TAPS的案例,通过及时干预成功管理.
- 倡导在怀孕16周开始TAPS监测.
主要方法:
- 病例报告:一个单性怀孕,在怀孕16周时被诊断出III期TAPS.
- 使用多普勒评估MCA峰值缩速度 (PSV) 和动脉流量.
- 在怀孕17周时通过胎镜激光光凝血治疗控制了这种情况.
主要成果:
- 发现了不一致的MCA PSV (1.8和0.7 MoM) 和动脉中缺少末端透静流.
- 通过胚胎镜激光切除静脉血管的成功管理.
- 由于胎儿生长受限,31周分娩;新生儿在出院时血红蛋白水平正常.
结论:
- 在妊娠16周开始MCA PSV多普勒监测对于早期TAPS检测至关重要.
- 在早期严重的TAPS中及时干预可以带来有利的新生儿结果.
- 这一案例支持较早的高风险单胎怀孕查方案.
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