CAJ | 학술논문

目的探讨双胎反向动脉灌注序列征(TRAP)的产前超声表现与分娩后胎盘血管铸型的关系.方法 6例TRAP孕妇接受产前超声检查,妊娠结束后行胎盘血管铸型.结果本组TRAPⅣ型3例,Ⅱ型2例,Ⅰ型1例.胎盘血管铸型表现:6例无心畸胎与正常胎儿脐带血管之间均为动脉-动脉、静脉-静脉直接血管吻合,吻合血管表浅粗大,两条脐血管插入处间距离不等.6例中4例无心畸胎脐动脉和脐静脉在胎盘段仅为一根大的脐动脉与一根大的脐静脉,2例无心畸胎脐动脉和脐静脉在胎盘段可见较多血管分支.6例泵血儿中4例死亡,2例存活.结论超声声像图与胎盘血管铸型有较好的一致性,有助于为深入研究TRAP的特殊血管吻合类型和预后提供有价值的信息.
목적 탐토쌍태반향동맥관주서렬정(TRAP)적산전초성표현여분면후태반혈관주형적관계.방법 6례TRAP잉부접수산전초성검사,임신결속후행태반혈관주형.결과 본조TRAPⅣ형3례,Ⅱ형2례,Ⅰ형1례.태반혈관주형표현:6례무심기태여정상태인제대혈관지간균위동맥-동맥、정맥-정맥직접혈관문합,문합혈관표천조대,량조제혈관삽입처간거리불등.6례중4례무심기태제동맥화제정맥재태반단부위일근대적제동맥여일근대적제정맥,2례무심기태제동맥화제정맥재태반단가견교다혈관분지.6례빙혈인중4례사망,2례존활.결론 초성성상도여태반혈관주형유교호적일치성,유조우위심입연구TRAP적특수혈관문합류형화예후제공유개치적신식.
Objective To investigate the relationship between the ultrasonography diagnosis in prenatal and the postnatal placental vascular casts of the twins reversed arterial perfusion(TRAP) sequence. Methods Six cases of TRAP sequence underwent the two-dimensional and color Doppler ultrasonography, and performed placental vascular casts after termination of pregnance. Results According to the anatomical features and ultrasonography, there were 3 cases of acardius acephalus( IV) ,2 cases of acardius anceps( II ) , and 1 case of acardius acormus( I ). In all 6 cases,there were arterio-arterial and veno-venous anastomoses at the level of the chorionic plate between the normal co-twin and the acardiac twin,these anastmosis vessels were superficial and large calibre, and the distances of the placental insertions of the umbilical cords were different,4 cases <0. 5 cm, 2 cases were 4-5 cm. In 4 cases, the vessels entered and went out of the acardiac twin were just one large umbilical artery and one large umbilical vein. In 2 cases, the umbilical artery and umbilical vein had many vascular branches in the placenta. Out of 6 cases of the pump twin, 4 cases died,and 2 cases survived. Conclusions Ultrasonography was consistent with the placental vascular casts,the contrast observing gives us new information for the further research of the special type of the vascular anastmosis and prognosis of the TRAP sequence.