河内妇产医院选择性激光脐带凝固治疗双胎输血综合征后早产的预后因素

Do Tuan Dat, Phan Thi Huyen Thuong, Nguyen Thi Thu Ha, Nguyen Duy Anh
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引用次数: 0

摘要

背景:双胎输血综合征(TTTS)是一种严重的并发症,影响10-15%的单绒毛膜双胎妊娠,其特征是胎儿之间血流不平衡,如果不治疗,可导致高发病率和死亡率。胎儿镜激光光凝已经成为标准的治疗方法,通过阻断异常的血管连接来提高生存率。目的:探讨影响双胎输血综合征(TTTS) II-IV期选择性激光脐带凝固术后早产风险的预后因素,为卵巢癌患者的治疗和诊断建立模型。方法:于2019年9月至2020年11月在河内市妇产医院胎儿医学中心进行前瞻性研究。21例诊断为TTTS的单绒毛膜双羊膜双胎妊娠接受了选择性激光脐带凝固。记录和分析胎龄、宫颈长度变化和手术结果。结果:平均出生胎龄34.7±4.3周,术后平均妊娠保留12.97周。早产占52.6%,34周前早产占31.6%。妊娠22周后进行手术,早产风险增加4.3倍(p = 0.025),而术后48小时内宫颈长度减少9.5%以上,早产风险增加8.7倍(p = 0.006)。结论:术中胎龄和术后宫颈长度减少是影响TTTS治疗后早产风险的关键因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prognostic Factors of Preterm Birth After Selective Laser Umbilical Cord Coagulation for Twin-twin Transfusion Syndrome at Hanoi Obstetrics and Gynecology Hospital.

Background: Twin-Twin Transfusion Syndrome (TTTS) is a serious complication affecting 10-15% of monochorionic diamniotic twin pregnancies, characterized by imbalanced blood flow between fetuses, which can lead to high morbidity and mortality if untreated. Fetoscopic laser photocoagulation has become the standard treatment, offering improved survival rates by interrupting abnormal blood vessel connections.

Objective: This paper focuses on creating models for treatment and diagnosis of patients suffering from Ovaria This study evaluates the prognostic factors influencing the risk of preterm birth after selective laser umbilical cord coagulation in cases of Twin-Twin Transfusion Syndrome (TTTS) stages II-IV.

Methods: A prospective study was conducted from September 2019 to November 2020 at the Fetal Medicine Center of Hanoi Obstetrics and Gynecology Hospital. Twenty-one monochorionic-diamniotic twin pregnancies diagnosed with TTTS underwent selective laser umbilical cord coagulation. Gestational age, cervical length changes, and surgical outcomes were recorded and analyzed.

Results: The mean gestational age at birth was 34.7 ± 4.3 weeks, with an average pregnancy retention of 12.97 weeks post-surgery. Preterm births occurred in 52.6% of cases, with 31.6% before 34 weeks. Surgery performed after 22 weeks of gestation increased the risk of preterm birth by 4.3 times (p = 0.025), while a cervical length reduction of more than 9.5% within 48 hours post-surgery raised the risk by 8.7 times (p = 0.006).

Conclusion: Gestational age at surgery and postoperative cervical length reduction are critical factors influencing the risk of preterm delivery following TTTS treatment.

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