单胎死亡的双胞胎贫血-红细胞增多症序列：围产期结局存活的双胞胎。

IF 6.1 1区医学 Q1 ACOUSTICS

Ultrasound in Obstetrics & Gynecology Pub Date : 2025-05-19 DOI:10.1002/uog.29242

M J A van de Sande, E Lopriore, M Lanna, Y Ville, L Lewi, A S Weingertner, G Ryan, L Otaño, P Klaritsch, A M B Blanco, E Bevilacqua, F Slaghekke, L S A Tollenaar

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引用次数: 0

摘要

目的：探讨双胎贫血-红细胞增多症（TAPS）单绒毛膜双胎自发性单次宫内死胎（IUFD）的围生儿结局。方法：这是一项回顾性研究，纳入2014年至2023年在国际TAPS登记处登记的所有接受自发性单次IUFD的单绒毛膜双胎妊娠。主要结局是存活的双胞胎的死亡率和新生儿严重脑损伤。结果：共纳入39例自发性单次IUFD的双胎妊娠，其中77%（30/39）在双胎输血综合征激光手术后发生TAPS， 23%（9/39）自发发生TAPS。单个IUFD主要发生在供体双胞胎中（35/39(90%)）。单次IUFD时的中位胎龄为23.0周（四分位间距（IQR）， 20.7-27.9周）。幸存的双胞胎出生时的中位胎龄为34.3周（IQR, 32.2-36.0）。双胞胎死亡1例（3%），原因是极度早产和宫内胎儿感染。幸存的双胞胎中没有一个新生儿有严重的脑损伤，也没有一个需要抢救宫内输血。结论：在双胎妊娠合并TAPS中，自发性单次IUFD后存活的双胞胎死亡和新生儿严重脑损伤的风险较低，这可能是由于通过微小胎盘吻合口减少了死后输血。©2025作者。妇产科学超声由John Wiley & Sons Ltd代表国际妇产科学超声学会出版。

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Single fetal demise in twin anemia-polycythemia sequence: perinatal outcome of surviving cotwin.

Objective: To evaluate the perinatal outcome after spontaneous single intrauterine fetal demise (IUFD) in monochorionic twin pregnancies with twin anemia-polycythemia sequence (TAPS).

Methods: This was a retrospective study of all monochorionic twin pregnancies with TAPS that underwent spontaneous single IUFD and were registered in the international TAPS Registry between 2014 and 2023. The primary outcomes were mortality and severe neonatal cerebral injury in the surviving cotwin.

Results: A total of 39 twin pregnancies with TAPS that underwent spontaneous single IUFD were included, of which 77% (30/39) developed TAPS after laser surgery for twin-twin transfusion syndrome and 23% (9/39) developed TAPS spontaneously. Single IUFD occurred mostly in the donor twin (35/39 (90%)). The median gestational age at single IUFD was 23.0 (interquartile range (IQR), 20.7-27.9) weeks. The median gestational age at birth of the surviving cotwin was 34.3 (IQR, 32.2-36.0) weeks. Cotwin death occurred in one (3%) case and was due to extreme prematurity and intrauterine fetal infection. None of the surviving cotwins had severe neonatal cerebral injury, nor did any require rescue intrauterine transfusion.

Conclusions: In twin pregnancy with TAPS, the risk of mortality and severe neonatal cerebral injury in the surviving cotwin after spontaneous single IUFD appears to be low, which is probably owing to reduced perimortem transfusion through minuscule placental anastomoses. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

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来源期刊

Ultrasound in Obstetrics & Gynecology 医学-妇产科学

CiteScore

12.30

自引率

14.10%

发文量

891

审稿时长

1 months

期刊介绍： Ultrasound in Obstetrics & Gynecology (UOG) is the official journal of the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) and is considered the foremost international peer-reviewed journal in the field. It publishes cutting-edge research that is highly relevant to clinical practice, which includes guidelines, expert commentaries, consensus statements, original articles, and systematic reviews. UOG is widely recognized and included in prominent abstract and indexing databases such as Index Medicus and Current Contents.