双胎之一胎死宫内的病因、处理及存活儿的预后

Single Intrauterine Fetal Death in Twin Pregnancies : Review of the Etiology , Management and Neonatal Outcomes

双胎之一胎死宫内(sIUFD)是双胎妊娠较复杂的一种并发症。其病因不同,则临床处理方案也不相同。妊娠中、晚期发生sIUFD,对存活儿的发病率和死亡率影响较大。单绒毛膜性(MC)双胎发生sIUFD时,存活胎的围生期死亡、脑损伤、早产等风险明显高于双绒毛膜性(DM)双胎。对其治疗需综合考虑病因、绒毛膜性、死胎发生时的孕龄及母体疾病等采取个体化的处理原则。笔者拟就sIUFD的病因、处理及存活儿的预后的研究进展,进行综述如下。

Single intrauterine fetal death（sIUFD）in twin pregnancies is a complex complication.Different death causes,different management.Death in the second or third trimester is associated with significant morbidity and mortality in the surviving twin.The risk of the surviving twin loss,cerebral impairment,and preterm birth in monochorionic（MC）twin pregnancies is obviously higher than that in dichorionic（DC）twin pregnancies.A management plan should be individualised,and should take the factors such as etiology,chorionicity,the gestation at which it occurs.,and maternal diseases into consideration.