[1]童春,魏瑗**,龚丽君,等.双胎输血综合征胎儿镜术后脐带缠绕1例报告[J].中国微创外科杂志,2017,17(10):951-953.
　Tong Chun,Wei Yuan,Gong Lijun,et al.Cord Entanglement After Laser Surgery for Twin-twin Transfusion Syndrome: Case Report[J].Chinese Journal of Minimally Invasive Surgery,2017,17(10):951-953.
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双胎输血综合征胎儿镜术后脐带缠绕1例报告()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年10期
页码:
951-953
栏目:
病例报告
出版日期:
2017-10-20

文章信息/Info

Title:
Cord Entanglement After Laser Surgery for Twin-twin Transfusion Syndrome: Case Report
作者:
童春; 魏瑗**; 龚丽君; 郭晓玥
北京大学第三医院妇产科，北京100083
Author(s):
Tong Chun;  Wei Yuan;  Gong Lijun;  et al.
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100083, China
关键词:
双胎输血综合征; 胎儿镜下胎盘交通血管激光凝固术; 脐带缠绕; 羊膜分隔破裂
Keywords:
Twin-twin transfusion syndrome; Fetoscopic laser occlusion of chorioangiopagous vessels; Cord entanglement; Perforation of intertwin membrane
文献标志码:
D
摘要:
本文报道我院2017年1月1例双胎输血综合征胎儿镜下胎盘交通血管激光凝固（fetoscopic laser occlusion of chorioangiopagous vessels，FLOC）术后脐带缠绕。本例双胎输血综合征于孕22周行FLOC，术后规律产检、超声随访，胎儿生长发育好，孕34周时提示两胎儿脐带缠绕，遂行剖宫产术，术中单羊膜腔，可见分离羊膜片，明确诊断脐带缠绕。我们认为双胎输血综合征胎儿镜术后序贯超声监测非常重要，对于术中跨膜凝固交通血管者尤其需要警惕羊膜分隔破裂致脐带缠绕这一极少见的术后并发症。
Abstract:
This study reported a case of cord entanglement after laser surgery for twin-twin transfusion syndrome (TTTS) in January 2017. At gestational age of twenty-two weeks this case of TTTS was treated with fetoscopic laser occlusion of chorioangiopagous vessels (FLOC). After treatment, ultrasound examinations were performed every two weeks. At gestational age of thirty-four weeks, ultrasound examination found suspected cord entanglement. A preterm cesarean section was performed in 24 hours and cord entanglement was confirmed with single amniotic cavity and free amniotic membrane. Our finding points out that follow-up ultrasound examination is very important for TTTS patients. For those undergoing transmembrane coagulation of branched vessels, it should be careful of perforation of intertwin membrane leading to cord entanglement after FLOC.

参考文献/References:

[1]Society for Maternal-Fetal Medicine,Simpson LL. Twin-twin transfusion syndrome. Am J Obstet Gynecol,2013,208(1):3-18.
[2]Berghella V, Kaufmann M. Natural history of twin-twin transfusion syndrome. J Reprod Med,2001,45(5):480-484.
[3]Akkemans J, Peeters SH, Middeldorp. A worldwide survey of laser survery for twin-twin transfusion syndrome. Ultrasound Obstet Gynecol,2015,45(2):168-174.
[4]Hernández-Andrade E，Guzmán-Huerta M, Benavides-Serralde JA, et al. Laser ablation of the placental vascular anastomoses for the treatment of twin-to-twin transfusion syndrome. Rev Invest Clin,2011,63(1):46-52.
[5]Papanna R, Molina S, Moise KY, et al. Chorioamnion plugging and the risk of preterm premature rupture of membranes after laser surgery in twin-twin transfusion syndrome. Ultrasound Obstet Gynecol,2010,35:337-343.
[6]Gruz-Martinez Z, Van Mieghem T, Lewi L, et al. Incidence and clinical implications of early inadvertent septostomy after laser therapy for twin-twin transfusion syndrome. Ultrasound Obstet Gynecol,2011,37(4):458-462.
[7]Peeters SH, Stolk TT, Slaghekke F, et al. Iatrogenic perforation of intertwin membrane after laser surgery for twin-to-twin transfusion syndrome. Ultrasound Obstet Gynecol,2014,44:550-556.

备注/Memo

备注/Memo:
基金项目：国家生殖健康及重大出生缺陷防控研究专项（项目编号：2016YFC1000400）**通讯作者,E-mail:weiyuanbysy@163.com
更新日期/Last Update: 2018-01-11