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首页> 外文期刊>Obstetrics and Gynecology: Journal of the American College of Obstetricians and Gynecologists >Monochorionic high-order multiple pregnancies and multifetal pregnancy reduction.
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Monochorionic high-order multiple pregnancies and multifetal pregnancy reduction.

机译：单绒毛膜高位多胎妊娠和多胎妊娠减少。

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OBJECTIVE: To study the frequency and obstetric outcome of monochorionic multiple pregnancies in a population referred for fetal reduction. METHODS: Data charts of all patients with multifetal (> or =3) pregnancies referred for fetal reduction over the last 10 years were reviewed for the presence of monochorionic twin pairs or triplets. RESULTS: Twenty-nine of 239 high-order multiple pregnancies contained a monochorionic component (12.1%), eight of which were monochorionic triplets. Half of all naturally conceived pregnancies contained a monochorionic component. High-order multiple pregnancies with a monochorionic component resulted significantly more frequently from natural conceptions (7 of 29) than multichorionic pregnancies (7 of 210) (P =.001). Fetal reduction of the monochorionic twin pair in 21 pregnancies resulted in eight twin and 13 singleton pregnancies; mean gestational age at delivery was, respectively, 34.3 +/- 2.9 and 39.2 +/- 1.4 weeks. Pregnancy loss rate was one of 21 (4.8%). In the remaining eight multiple pregnancies with a monochorionic triplet present, three were complicated by a twin reversed arterial perfusion sequence, and two couples requested a first trimester termination of pregnancy. Fetal reduction of the monochorionic triplet in a dichorionic quadruplet pregnancy resulted in a normal pregnancy outcome. In two monochorionic triplet pregnancies, fetal reduction to monochorionic twin pregnancies with bipolar coagulation of the umbilical cord resulted in a favorable pregnancy outcome. CONCLUSION: Monochorionic twins or triplets are frequently part of naturally conceived high-order multiple pregnancies. Reduction of the monochorionic twin pairs improves pregnancy outcome. Monochorionic triplet pregnancies show a high complication rate, but may benefit from fetal reduction by cord coagulation.
机译：目的：研究在减少胎儿数量的人群中单绒毛膜多胎妊娠的频率和产科结局。方法：回顾了过去10年中所有因减少胎儿而接受多胎（>或= 3）妊娠的患者的数据图表，检查是否存在单绒毛膜双胞胎或三胞胎。结果：239例高次多胎妊娠中有29例包含单绒毛膜成分（12.1％），其中八种是单绒毛膜三胞胎。所有自然怀孕的孕妇中有一半含有单绒毛膜成分。具有自然绒毛成分的高次多次妊娠比自然绒毛妊娠（29个中的7个）产生的频率要高得多（29个中的7个）（P = .001）。单胎绒毛双胞胎对21胎的胎儿减少导致8胎双胞胎和13胎单胎妊娠。分娩时的平均胎龄分别为34.3 +/- 2.9周和39.2 +/- 1.4周。怀孕率是21例之一（4.8％）。在剩下的八例单绒毛膜三联体多胎妊娠中，三例因双生子反向动脉灌注序列而变得复杂，两对夫妇要求孕早期终止妊娠。二绒毛四联体妊娠中胎儿单绒毛膜三联体的胎儿减少导致正常的妊娠结局。在两个单绒毛膜三胞胎妊娠中，胎儿双脐带双凝凝结后变为单绒毛膜双胞胎妊娠，妊娠结果良好。结论：单绒毛膜双胞胎或三胞胎通常是自然设想的高次多胎妊娠的一部分。单绒毛膜双胞胎对的减少可改善妊娠结局。单绒毛膜三联体妊娠显示出较高的并发症发生率，但可能受益于脐带凝结使胎儿减少。

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