doi:10.7504/fk2015060103

Abstract

Key words: multiple pregnancy, fetus malformation, sonography, fetus ECG, MRI, prenatal diagnosis

摘要：

近20年来，随着人类辅助生殖技术的日益成熟和体外受精-胚胎移植（in vitro fertilization and embryo transfer，IVF-ET）妊娠的增多，多胎妊娠发生率明显升高，其母儿结局亦引起人们关注。本文重点阐述多胎妊娠胎儿畸形的筛查方法及产前诊断。

关键词: 多胎妊娠, 胎儿畸形, 超声检查, 胎儿超声心动图, 磁共振成像, 产前诊断

CLC Number:

R714.23

陈敦金，李志华. 重视多胎妊娠胎儿畸形筛查与诊断[J]. 中国实用妇科与产科杂志, DOI: 10.7504/fk2015060103.

［1］   Ferraretti AP，Goossens V，Kupka M，et al. Assisted reproductive technology in Europe，2009：results generated from European registers by ESHRE［J］. Hum Reprod，2013，28：2318-2331.

［2］    Sunderam S，Kissin DM，Flowers L，et al. Assisted reproductive technology surveillance—United States，2009［J］. MMWR Surveill Summ，2012，61：1-23.

［3］   Bahtiyar MOL，Dulay AT，Weeks BP，et al. Prevalence of congenital heart defects in monochorionic/diamniotic twin gestations：a systematic literature review［J］. J Ultrasound Med，2007，26（11）：1491-1418.

［4］ Machin G. Non-identical monozygotic twins，intermediate twin types，zygosity testing，and the non-random nature of monozygotic twinning：a review［J］. Am J Med Genet C Semin Med Genet，2009，151C（2）：110-127.

［5］   Pruetz JDL，Sklansky M，Detterich J，et al. Twin-twin transfusion syndrome treated with laser surgery：postnatal prevalence of congenital heart disease in surviving recipients and donors［J］. Prenat Diagn，2011，31（10）：973-977.

［6］   Vink J，Wapner R，D'Alton ME. Prenatal diagnosis in twin gestations. Semin Perinatol［J］. 2012，36（3）：169-174.

［7］    Nobili E，Paramasivam G，Kumar S. Outcome following selective fetal reduction in monochorionic and dichorionic twin pregnancies discordant for structural，chromosomal and genetic disorders［J］. Aust N Z J Obstet Gynecol，2013，53（2）：114-118.

［8］    Mahalingam SL，Dighe M. Imaging concerns unique to twin pregnancy［J］. Curr Probl Diagn Radiol，2014，43（6）：317-330.

［9］   Kristiansen MK，Joensen BS，Ekelund CK，et al. Perinatal outcome after ?rst-trimester risk assessment in monochorionic and dichorionic twin pregnancies：a population-based register study［J］. BJOG，2015，DOI：10. 1111/1471-0528. 13326.

［10］   Monteagn DA，Roman AS. Ultrasound in multiple gestational twins and other multifetal pregnancies［J］. Clin Perinatal，2005，32（2）：329-354.

［11］   Sepulveda W，Sebire NJ，Hughes K，et al. Evolution of the lambda or twin-chorionic peak sign in dichorionic twin pregnancies［J］. Obstet Gynecol，1997，89：439-441.

［12］   Frates M，Kumar AJ，Benson CB，et al. Fetal anomalies：comparison of MR imaging and US for diagnosis［J］. Radiology，2004，232：398-404.

［13］    Syngelaki AL，Chelemen T，Dagklis T，et al. Challenges in the diagnosis of fetal non-chromosomal abnormalities at 11-13 weeks［J］. Prenat Diagn，2011，31（1）：90-102.

［14］    DeJesus ASO，Javitt MC，Glanc P，et al. ACR appropriateness Criteria multiple gestations［J］. Ultrasound Q，2012，28（2）：149-155.

［15］    Randall P，Brealey S，Hahn S，et al. Accuracy of fetal echocardiography in the routine detection of congenital heart disease among unselected and low risk populations：a systematic review［J］. BJOG，2005，112：24-30.

［16］    Paladini D，Vassallo M，Sglavo G，et al. Diagnosis and outcome of congenital heart disease in fetuses from multiple pregnancies［J］. Prenat Diagn，2005，25：403-406.

［17］    Van Mieghem T，Hodges R，Jaeggi E，et al. Functional echocardiography in the fetus with non-cardiac disease［J］. Prenat Diagn，2014，34（1）：23-32.

［18］    Moon-Grady AJ. Fetal echocardiography in twin-twin transfusion syndrome［J］. Am J Perinatol，2014，Suppl 1：S31- S38.

［19］    Pereira S，Ganapathy R，Syngelaki A，et al. Contribution of fetal tricuspid regurgitation in first-trimester screening for major cardiac defects［J］. Obstet Gynecol，2011，117：1384-1391.

［20］    Sepulveda W，Ximenes R，Wong AE，et al. Fetal magnetic resonance imaging and three-dimensional ultrasound in clinical practice：applications in prenatal diagnosis［J］. Best Pract Res Clin Obstet Gynaecol，2012，26（5）：593-624.

［21］   Sato H，Murata H，Sato K，et al. Encephalomalacia in surviving twin after single fetal death diagnosed at 18 weeks of gestation in monochorionic twin pregnancy［J］. Am J Case Rep，2013，14：341-344.

［22］   Prayer D，Brugger PC，Kasprian G，et al. MRI of fetal acquired brain lesions［J］. Eur J Radiol，2006，57：233-249.

［23］   Werner H，dos Santos JR，Fontes R，et al. Additive manufacturing models of fetuses built from three-dimensional ultrasound，magnetic resonance imaging and computed tomography scan data［J］. Ultrasound Obstet Gynecol，2010，36（3）：355-361.

［24］   Duncan KR，Denbow ML，Fisk NM. The aetiology and management of twin—twin transfusion syndrome［J］. Prenat Diagn，1997，17：1227-1236.

［25］   Gul A，Asian H，Polat I，et al.Natural history of ll cases of twin twin transfusion syndrome without intervention［J］. Twin Res，2003，6：263-266.

［26］   Quintero RA，Morales WJ，Allen MH，et al. Staging of twin-twin transfusion syndrome［J］. J Perinatol，1999，19（8Pt1）：550-555.

［27］   Rychik J，Tian Z，Bebbington M，et al. The twin-twin transfusion syndrome：spectrum of cardiovascular abnormality and development of a cardiovascular score to assess severity of disease［J］. Am J Obstet Gynecol，2007，197（4）：e1-e8.

［28］   Matias A，Montenegro N，Loureiro T，et al. Screening for twin-twin transfusion syndrome at 11-14 weeks of pregnancy：the key role of ductus venosus blood flow assessment［J］. Utrasound Obstet Gynecol，2010，35：142-148.

［29］   Costa-Castro T，De Villiers S，Montenegro N，et al. Velamentous cord insertion in monochorionic twins with or without twin-twin transfusion syndrome：does it matter? ［J］. Placenta，2013，34（11）：1053-1058.

［30］   Carver A，Haeri S，Moldenhauer J，et al. Monochorionic diamniotic twin pregnancy：timing and duration of sonographic surveillance for detection of twin-twin transfusion syndrome［J］. J Ultrasound Med，2011，30（3）：297-301.

［31］   O’Connor C，McAuliffe FM，Breathnach FM，et al. Perinatal Ireland Research Consortium. Prediction of outcome in twin pregnancy with ?rst and early second trimester ultrasound［J］. J Matern Fetal Neonatal Med，2013，26（10）：1030-1035.

［32］   D’Antonio F，Khalil A，Dias T，et al. Southwest Thames Obstetric Research Collaborative （STORK）. Weight discordance and perinatal mortality in twins：analysis of the Southwest Thames Obstetric Research Collaborative （STORK） multiple pregnancy cohort［J］. Ultrasound Obstet Gynecol，2013，41：643-648.

［33］   Miller J，Chauhan SP，Abuhamad AZ. Discordant twins：diagnosis，evaluation and management［J］. Am J Obstet Gynecol，2012，206：10-20.

［34］   Simoes T，Julio C，Cordeiro A，et al. Abdominal circumference ratio for the diagnosis of intertwin birth weight discordance［J］. J Perinat Med，2011，39：43-46.

［35］   Ong S，Zamora J，Khan K，et al. Single twin demise：consequences to the survivor. In：Kilby MD，Baker P，Critchley H，ed.Multiple pregnancy［J］. RCOG Press，2006，149-165.

［36］   Shek NW，Hillman SC，Kilby MD. Single-twin demise：pregnancy outcome［J］. Best Pract Res Clin Obstet Gynecol，2014 ，28（2）：249-263.

［37］   Sperling LL，Kiil C，Larsen LU，et al. Detection of chromosomal abnormalities，congenital abnormalities and transfusion syndrome in twins［J］. Ultrasound Obstet Gynecol，2007，29（5）：517-526.

［38］   Glinianaia SVL，Rankin J，Wright C. Congenital anomalies in twins：a register-based study［J］. Hum Reprod，2008，23（6）：1306-1311.

［39］   Nieuwint AL，Van Zalen-Sprock R，Hummel P，et al. Identical twins with discordant karyotypes［J］. Prenat Diagn，1999，19（1）：72-76.

［40］   Weisz B，Rodeck CH. Invasive diagnostic procedures in twin pregnancies［J］. Prenat Diagn，2005，25：751-758.

（2015-04-01收稿）

[1]	. [J]. Acta Metallurgica Sinica, 2021, 37(5): 550-553.
[2]	. [J]. Acta Metallurgica Sinica, 2021, 37(3): 312-316.
[3]	LI Ze-li, CHEN Lian, ZHAO Yang-yu. Application value of molecular biomarkers in prenatal diagnosis of placenta accreta spectrum disorders. [J]. Chinese Journal of Practical gynecology ang obstetric, 2021, 37(11): 1105-1108.
[4]	. [J]. Acta Metallurgica Sinica, 2020, 36(9): 797-799.
[5]	JIANG Yu-lin，LIU Jun-tao. The prenatal genetic counseling of advanced maternal age. [J]. Acta Metallurgica Sinica, 2020, 36(9): 811-814.
[6]	ZOU Gang，SUN Lu-ming. Prenatal screening，diagnosis and intrauterine therapy for twin pregnancy：referral is the key. [J]. Acta Metallurgica Sinica, 2020, 36(9): 814-817.
[7]	. [J]. Acta Metallurgica Sinica, 2020, 36(8): 673-675.
[8]	CHEN Bing-nan，QIAO Chong. Serial ultrasonography to predict adverse pregnancy outcomes in the third trimester. [J]. Acta Metallurgica Sinica, 2020, 36(5): 419-423.
[9]	CAI Lu-yao，SUN Lu-ming. Assessment of prenatal diagnosis testing in twin pregnancies. [J]. Acta Metallurgica Sinica, 2020, 36(2): 101-104.
[10]	SONG Ting. Value of CT and MRI in the diagnosis of adnexal masses. [J]. Acta Metallurgica Sinica, 2020, 36(12): 1157-1160.
[11]	LU Jing-jing，SUN Meng-yan. Progress in the application and research of MRI in uterine adenomyosis. [J]. Acta Metallurgica Sinica, 2019, 35(5): 505-509.
[12]	WEI Xing，SUN Lu-ming. Fetal arrhythmia：prenatal diagnosis and management. [J]. Acta Metallurgica Sinica, 2019, 35(4): 392-396.
[13]	LIU Xing，CA0 Yin-li. Fetal monitoring during twin pregnancy. [J]. Acta Metallurgica Sinica, 2019, 35(4): 387-392.
[14]	MAO Yun-dong. Choice of diagnostic methods in tubal obstructive diseases. [J]. Acta Metallurgica Sinica, 2019, 35(1): 68-72.
[15]	CHEN Chun-lin，MENG Fan-liang. Problems that should be emphasized in the diagnosis and treatment of tubal pregnancy. [J]. Acta Metallurgica Sinica, 2019, 35(1): 59-64.

重视多胎妊娠胎儿畸形筛查与诊断

PDF

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Recommended Articles

Metrics