双胎妊娠胎盘特征及其临床预后

Placental characteristic and clinical prognosis of twin gestation

双胎妊娠较单胎妊娠更容易发生胎儿异常及胎盘异常。双胎妊娠中的一些胎盘异常在单胎妊娠中也可发生,如前置胎盘、胎盘早剥等。然而,有些胎盘异常是双胎妊娠所特有的,且主要与单绒毛膜双胎有关,如胎盘内血管异常融合等。这些情况大多数可以用超声诊断,包括测定绒毛膜性、羊膜性以及胎盘异常的识别。分娩后胎盘病理检查可以帮助评估胎盘异常的存在,提供关于绒毛膜性的信息,了解双胎妊娠疾病的胎盘相关发病机制。

With the development of the application of assisted reproductive technologies and the increasing of maternal age, the frequency of twin gestations has increased severely. The risk of fetal structural anom- alies and placental abnormalities in twins is much higher compared with singleton. Some of the nonspe- cific placental abnormalities can be found in twin gestations which can also be seen in singleton gesta- tions, such as placenta previa, placental abruption, etc. However, other anomalies are unique to twin gestations, and are mainly associated with monochorionic twins, which include intraplacental anastomosis. Most of abnormalities can be diagnosed with ultrasound, in- cluding determination of chorionicity and amnionicity, and the identification of placental anomalies. Patho- logic placental examination after delivery is useful in assessing the presence of placental abnormalities, as well as providing information about chorionicity and understanding the potential mechanisms of disease affecting twin gestations.