双胎合并胎儿异常的产前诊断与预后

Prenatal diagnosis and prognosis of fetal anomaly combined with twin pregnancy

目的:探讨双胎合并胎儿异常的产前诊断、临床处理及预后,为临床遗传咨询和优生优育提供依据。方法:回顾性分析该院产前B超诊断的双胎合并胎儿异常的18例患者的相关资料,记录其临床处理、B超随访及新生儿情况。结果:18例中11例为1胎正常、1胎异常;4例两个胎儿均异常;3例联体双胎。10例继续妊娠,8个新生儿存活,其中7个(出生后2～12个月)未见明显异常。结论:对于B超产前诊断双胎合并1个胎儿异常者若继续妊娠,孕期应严密监测,积极产科处理,适时终止妊娠,可以提高围产儿的存活率。

Objective： To explore the prenatal diagnosis, clinical treatment and prognosis of fetal anomaly combined with twin pregnancy, provide a basis for clinical genetic counseling and bearing and rearing better children. Methods： Clinical data of 18 cases of fetal anomaly combined with twin pregnancy diagnosed by prenatal ultrasound in the hospital were analysed retrospectively, the clinical treatment, followup ultrasound results and neonatal status were recorded. Results： Among 18 cases of fetal anomaly combined with twin pregnancy, 11 cases had only one fetal anomaly, 4 cases had two fetal anomalies and 3 cases had conjoined twins. 10 cases continued pregnancy, 8 neonates were alive, and 7 neonates were healthy （2 - 12 months after birth） . Conclusion： For the cases continuing pregnancy after diagnosed as twin pregnancy with one fetal anomaly in prenatal diagnosis, comprehensive monitoring, active obstetric treatment and timely terminating pregnancy may increase the survival rate of perinatal infants.