超声在“固定胎”病因学诊断中的应用

Application of ultrasonography in etiological diagnosis of "stuck twin"

目的探讨超声检查在"固定胎"病因学诊断中的应用价值。方法对12例"固定胎"的超声表现进行分析,并通过随访病程进展对超声诊断结果进行验证。结果 12例中,6例初次超声检查即诊断为"固定胎",6例为超声随访过程中发现形成"固定胎";超声诊断"固定胎"病因为选择性一胎宫内生长受限(sIUGR)6例,双胎输血综合征(TTTS)3例,双胎之一双肾多囊性发育不良1例,人鱼序列征1例,另1例超声未能做出病因学诊断。除1例超声未能做出病因学诊断者外,余11例在终止妊娠或分娩后临床均证实超声诊断。结论产前超声检查有助于"固定胎"病因学诊断,通过对脐带插入点、羊水量、胎儿心血管系统进行超声评估可推测"固定胎"病因。

Objective To evaluate the application value of ultrasonography in the etiological diagnosis of ＂ stuck twin＂ phenomenon.Methods Features of 12 pregnant women with ＂stuck twin＂ diagnosed by ultrasonography were analyzed.And the ultrasound results were verified follow-up.Results Among 12 cases,6cases of ＂stuck twin＂ were diagnosed by the first ultrasonography and the other 6cases were diagnosed during follow-up observation.According to ultrasound results,the phenomenon of ＂stuck twin＂ caused by selective intrauterine growth restriction（sIUGR）in 6cases,twin to twin transfusion syndrome（TTTS）in 3cases,fetal polycystic renal dysplasia in 1case,caudal regression syndrome in 1case.No specific reason was found by ultrasonography in the other 1case.All of the ultrasound results were confirmed by clinic after delivery or termination of pregnancy,except 1case without specific result by ultrasonography.Conclusion Ultrasonography is helpful to explore the factors of ＂stuck twin＂.The etiological diagnosis can be inferred by evaluating the insertion point of the umbilical cord,the amniotic fluid and the cardiovascular system.