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双胎输血综合征并非罕见,并且是双胎死亡率的主要原因之一,故应引起重视。产前诊断主要依靠B超,若妊娠中期出现急性羊水过多,就要怀疑该病。生后诊断主要是应将胎盘检查、双胎的血型、血色素和体重测定作为常规。诊断依据是:①确定双胎血型是否相同,是不是单合子胎盘,有无血管吻合。②血色素必须相差5g/dl以上,如胎盘有动静脉吻合,体重相差大于20%则高度提示慢性型。降低死亡率的关键是及时换血和输血,防治胎死宫内和控制早产发生。
Twin twin transfusion syndrome is not uncommon, and is one of the main causes of twin mortality, it should be taken seriously. Prenatal diagnosis depends mainly on B-ultrasound, if there is acute polyhydramnios in mid-pregnancy, we must suspect the disease. Postnatal diagnosis should be placental examination, twins blood type, hemoglobin and body weight determination as a routine. The diagnosis is based on: ① determine the twin blood type is the same, is not a monocular placenta, with or without vascular anastomosis. ② hemoglobin must be more than 5g / dl above, such as placental arteriovenous anastomosis, body weight more than 20% difference is highly suggestive of chronic type. The key to reduce mortality is timely exchange transfusion and blood transfusion, control of fetal death and preterm birth.