单羊膜双胞胎妊娠合并胎儿先天性心脏缺陷-围产期决定的挑战

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY
M. Pasieczna, Joanna Kuran-Ohde, A. Kajdy, D. Filipecka-Tyczka, Natalia Świątek, J. Szymkiewicz-Dangel
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引用次数: 1

摘要

摘要目的分析单绒毛膜单羊膜(MCMA)妊娠合并先天性心脏缺陷(CHD)的妊娠管理和产后随访,并将结果与目前关于MCMA妊娠分娩时间和方式的建议进行比较。分析了5对转至胎儿心脏科的单羊膜双胞胎的围产期医疗记录。23例MCMA妊娠中有5例(21.7%)合并1例胎儿冠心病。在妊娠32 ~ 35周(WoG)行剖宫产术(CS)。10个新生儿中有9个呼吸衰竭,包括所有冠心病患者。没有先天性异常的双胞胎在新生儿病房中位数为21天(范围为10-40天)。冠心病患者平均在出生后第6天转到心内科。所有患者均为晚于足月出生的新生儿,5例中有4例需要分期手术,住院时间中位数为75天(48-106天)。结论根据目前的建议,MCMA妊娠的分娩应安排在32-34周。如果双胞胎中有一人并发冠心病,这种早产会使手术治疗复杂化,并可能影响最终结果。低体重和呼吸系统疾病增加围手术期并发症的发生风险,延长住院时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Monoamniotic twins pregnancy complicated by a fetal congenital heart defect – a challenge for perinatal decisions
Abstract Objectives To analyze pregnancy management and postnatal follow-up in monochorionic monoamniotic (MCMA) pregnancies complicated by a congenital heart defect (CHD) in one twin and to compare the results with current recommendations concerning time and mode of delivery in MCMA pregnancies. Cases presentation Perinatal medical records of five pairs of monoamniotic twins referred to Fetal Cardiology Department were analyzed. 5 out of 23 MCMA pregnancies (21.7%) were complicated by CHD in one fetus. Cesarean section (CS) was performed between 32 and 35 weeks of gestation (WoG). 9 out of 10 neonates had respiratory failure, including all patients with CHD. Twins without congenital abnormalities spent median 21 days (range 10–40 days) in neonatal units. Patients with CHD were transferred to cardiology departments on average 6th day of life. All were operated on later than term-born neonates, 4 out of 5 required stage surgery and their median stay in the hospital was 75 days (range 48–106 days). Conclusions According to current recommendations, delivery in MCMA pregnancies should be scheduled at 32–34 weeks. In cases complicated by CHD in one twin, such early delivery complicates surgical treatment and may affect the final outcome. Low body weight and respiratory disorders increase the risk of complications in the perioperative period and prolong hospitalization.
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来源期刊
Case Reports in Perinatal Medicine
Case Reports in Perinatal Medicine OBSTETRICS & GYNECOLOGY-
自引率
0.00%
发文量
37
期刊介绍: Case Reports in Perinatal Medicine is a double-blind peer-reviewed journal. The objective of the new journal is very similar to that of JPM. In addition to evidence-based studies, practitioners in clinical practice esteem especially exemplary reports of cases that reveal specific manifestations of diseases, its progress or its treatment. We consider case reports and series to be brief reports describing an isolated clinical case or a small number of cases. They may describe new or uncommon diagnoses, unusual outcomes or prognosis, new or infrequently used therapies and side effects of therapy not usually discovered in clinical trials. They represent the basic concept of experiences for studies on representative groups for further evidence-based research. The potential roles of case reports and case series are: Recognition and description of new diseases Detection of drug side effects (adverse or beneficial) Study of mechanisms of disease Medical education and audit Recognition of rare manifestations of disease.
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