双胎输血综合征射频消融减胎后成功分娩1例并文献复习

A case of successful delivery after radiofrequency ablation in pregnant women with twin-twin transfusion syndrome and literature review

目的探讨经射频消融减胎术后发生未足月胎膜早破的双胎输血综合征孕妇的处理方案。方法收集2018年1例孕16+2周双胎输血综合征经射频消融减胎后胎膜早破期待治疗的孕妇。结果孕34+1周,射频消融减胎术后18+周,在持续硬膜外麻醉下行经腹子宫下段横切口剖宫产术,先娩出一活男婴,评分9(肤色扣1分)-10-10分,体质量2430 g,再娩出一纸样死胎,体质量300 g。随访新生儿至半岁,各项生长发育指标均正常。结论经射频消融减胎术后发生未足月胎膜早破的双胎输血综合征孕妇在确认无羊膜腔感染的情况下可期待治疗,孕34~35周适时终止妊娠。

Objective To explore the treatment of preterm premature rupture of membranes after radiofrequency ablation in pregnant women with twin-twin transfusion syndrome.Methods The information of a case who accepted expectant treatment for preterm premature rupture of membranes after radiofrequency ablation for twin-twin transfusion syndrome at 16+2 weeks in 2018 was collected.Results The pregnant woman was terminated pregnancy until 34+1 weeks.18+weeks after radiofency ablation for fetal reduction,caesarean section through the lower abdominal section of the uterus was performed under continuous epidural anesthesia.A live baby boy was delivered first,with a score of 9(skin color,minus 1 point)and a body mass of 2430 g,followed by a paper stillbirth with a body mass of 300 g.The newborns were followed up to half a year old,and all the growth and development indicators were normal.Conclusion If preterm premature rupture of membranes follows after radiofrequency ablation for twin-twin transfusion syndrome,expectant treatment to 34-35 gestational weeks may be an appropriate choice in the case of women without amniotic cavity infection.