Tóm tắt
Background: Monochorionic twins are a high risk pregnancy and are associated with special complications that are unique to sharing a placenta and because of the hemodynamic imbalance caused by placental vascular anastomoses. Therefore, the outcome of monochorionic twins is still being researched and reported to looking for the best evidence to perform the optimal interventions.
Objectives: To describe the outcome of monochorionic twins to determine the proportion of special complications. Moreover, exploring the rate of fetal death in uterus, premature delivery, the successful vaginal birth in complicated monochorionic twins after bipolar cord coagulation.
Materials and Methods: Case series report of monochorionic twins which was managed pregnancy and delivered at Tu Du hospital between January 2018 and January 2019, comprised 166 cases with 81 complicated monochorionic twin pregnancies.
Results: The series comprised 85 uncomplicated monochorionic twins (51.2%) and 81 complicated cases (48.8%) with 15% twin-twin transfusion syndrome (TTTS) and 28.3% selective intrauterine growth restriction (sIUGR). Nineteen cases of bipolar cord coagulation perfomed included seven TTTS, eight sIUGR, three cases with serious malformation, and one twin reversed arterial perfusion sequence (TRAP).
Conclusions: TTTS and sIUGR are complications unique to monochorionic twins and diagnosed in the early stage after 23 week’s gestation. Bipolar cord coagulation is an effective procedure in complicated monochorionic pregnancies to improve pregnancy outcome.
Tài liệu tham khảo
2. Cordero Leandro, Franco Albert, Joy Saju D., O'Shaughnessy Richard W. (2005), Monochorionic Diamniotic Infants Without Twin-to-Twin Transfusion Syndrome. Journal of Perinatology, 25 (12), pp. 753-758.
3. Ashwal E, Yinon Y, Fishel-Bartal M, et al (2016). Twin Anemia-Polycythemia Sequence: Perinatal Management and Outcome. Fetal Diagnosis and Therapy, 40(1):28-34.
4. Ajmi Ayesha and Rauf Saima (2019). Timing and Mode of Delivery in Twin Pregnancy. EC Gynaecology 8.11: 71-75.
5. Hack KE, Derks JB, Elias SG, et al (2011). Perinatal mortality and mode of delivery in monochorionic diamniotic twin pregnancies ≥ 32 weeks of gestation: a multicentre retrospective cohort study. Bjog, 118(9):1090-7.
6. Emery Stephen P., Hasley Steve K., Catov Janet M., Miller Russell S., Moon-Grady Anita J, et al (2016). North American Fetal Therapy Network: intervention vs expectant management for stage I twin-twin transfusion syndrome. American Journal of Obstetrics & Gynecology, 215(3): 346.e1-346.e7.
7. Ishii K., Chmait R. H., Martínez J. M., Nakata M., Quintero R. A. (2004), Ultrasound assessment of venous blood flow before and after laser therapy: approach to understanding the pathophysiology of twin–twin transfusion syndrome. Ultrasound in Obstetrics & Gynecology, 24 (2), pp. 164-168.
8. Wang J, Luo J, Yang J, et al (2019). Analysis of clinical characteristics of discordant structural malformations in one of monochorionic diamnionic twins. Zhonghua fu chan ke za zhi, 54: 87-92.
9. Springer S, Mlczoch E, Krampl-Bettelheim E, Mailath-Pokorny M, Ulm B, et al (2014). Congenital heart disease in monochorionic twins with and without twin-to-twin transfusion syndrome. Prenat Diagn, 34(10): 994-9.
10. Lanna MM, Rustico MA, Dell'Avanzo M, Schena V, Faiola S, et al (2012). Bipolar cord coagulation for selective feticide in complicated monochorionic twin pregnancies: 118 consecutive cases at a single center. Ultrasound Obstet Gynecol, 39(4): 407-13.
11. Nakata M., Chmait R. H., Quintero R. A. (2004), Umbilical cord occlusion of the donor versus recipient fetus in twin–twin transfusion syndrome. Ultrasound in Obstetrics & Gynecology, 23 (5), pp. 446-450.
12. Rossi A. Cristina, D'Addario Vincenzo (2009), Umbilical cord occlusion for selective feticide in complicated monochorionic twins: a systematic review of literature. American Journal of Obstetrics & Gynecology, 200 (2), pp. 123-129.
Công trình này được cấp phép theo Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. . p>
Download
Cùng tác giả
- Trương Mỹ Ngọc, Đỗ Thị Minh Nguyệt, Trần Nhật Thăng, Hồ Viết Thắng, Vương Thị Ngọc Lan, Kết cục thai kỳ các trường hợp thai nhỏ so với tuổi thai , Tạp chí Phụ sản: Tập 18 Số 1 (2020): Tập 18, Số 1, 2020
- Nguyễn Khánh Duy, Nguyễn Thị Kim Mai, Trần Nhật Thăng, Chiến lược sinh trì hoãn trong thai kỳ đa thai: cơ hội và thách thức , Tạp chí Phụ sản: Tập 21 Số 4-5 (2023): Số đặc biệt chào mừng Hội nghị Sản Phụ Khoa Miền Trung - Tây Nguyên mở rộng lần X, năm 2023
- Nguyễn Hồng Hoa, Đinh Thị Vân Khanh, Kiến thức - thái độ về que cấy tránh thai Implanon của người phụ nữ sau sinh 6 - 12 tuần tại Bệnh viện Phụ sản MêKông trong giai đoạn đại dịch COVID-19 , Tạp chí Phụ sản: Tập 22 Số 1 (2024)