CAJ | 학술논문

目的：探讨孕11-13+6周双胎间头臀长（CRL）、颈项透明层厚度（NT）、最大羊水深度（DVP）的差异对复杂性双绒毛膜双羊膜囊双胎的预测价值。方法对212例孕11-13+6周行超声检查确定为双绒毛膜双羊膜囊双活胎的孕妇，随访至妊娠结束，评估双胎间CRL、NT、DVP的差异与复杂性双胎（包括双胎生长不一致、选择性宫内生长受限（sFGR）、双胎之一死胎、双胎之一畸形）的相关性。结果212例双绒毛膜双胎中有36例复杂性双胎（双胎之一死胎4例、双胎之一畸形2例，双胎生长不一致或选择性宫内生长受限30例）。复杂性双胎组即研究组早孕B超大小胎CRL、NT、DVP均值相比差异无统计学意义（P均>0.05）。非复杂性双胎组即对照组早孕B超大小胎NT、DVP均值相比差异无统计学意义（P均>0.05），CRL均值差异有统计学意义（t=1.326, P<0.01）。研究组与对照组相比，双胎间的CRL、NT、DVP差别均无统计学意义（P均>0.05）。结论非复杂性双胎在孕早期生长发育存在不均衡性，但孕早期双胎间CRL、NT、DVP的差异无法准确预测复杂性双绒毛膜双胎妊娠的发生。
목적：탐토잉11-13+6주쌍태간두둔장（CRL）、경항투명층후도（NT）、최대양수심도（DVP）적차이대복잡성쌍융모막쌍양막낭쌍태적예측개치。방법대212례잉11-13+6주행초성검사학정위쌍융모막쌍양막낭쌍활태적잉부，수방지임신결속，평고쌍태간CRL、NT、DVP적차이여복잡성쌍태（포괄쌍태생장불일치、선택성궁내생장수한（sFGR）、쌍태지일사태、쌍태지일기형）적상관성。결과212례쌍융모막쌍태중유36례복잡성쌍태（쌍태지일사태4례、쌍태지일기형2례，쌍태생장불일치혹선택성궁내생장수한30례）。복잡성쌍태조즉연구조조잉B초대소태CRL、NT、DVP균치상비차이무통계학의의（P균>0.05）。비복잡성쌍태조즉대조조조잉B초대소태NT、DVP균치상비차이무통계학의의（P균>0.05），CRL균치차이유통계학의의（t=1.326, P<0.01）。연구조여대조조상비，쌍태간적CRL、NT、DVP차별균무통계학의의（P균>0.05）。결론비복잡성쌍태재잉조기생장발육존재불균형성，단잉조기쌍태간CRL、NT、DVP적차이무법준학예측복잡성쌍융모막쌍태임신적발생。
Objective The purpose of this study was to determine whether first trimester ultrasound scanning can identify dichorionic twin gestations that are at risk for subsequent adverse outcome. Methods 212 dichorionic twin pregnancies that were assessed by ultrasound examinations between 11 and 13+6 weeks of gestation were followed. Inter-twin differences of crown-rump length (CRL) , nuchal translucency (NT) and deepest vertical pockets (DVP) were calculated and compared between those with normal outcome and those developing adverse outcome including growth discordance, selective fetal growth restriction (sFGR), fetal death of one twin and fetal malformation of one twin. Results Of 212 twin pregnancies, 36 pregnancies developed adverse outcome (4 fetal death of one twin, 2 fetal malformation of one twin and 30 growth discordance or sFGR). The inter-twin CRL, NT and DVP were not significantly different (all P>0.05) in adverse outcome group. The inter-twin NT and DVP were not significantly different (all P>0.05) in control group. The inter-twin CRL was significantly different (P<0.001) in control group. Inter-twin differences of CRL, NT and DVP were not significantly different between adverse outcome group and normal outcome group. Conclusions First-trimester CRL, NT and DVP inter-twin differences were not predictive of subsequent adverse outcome in dichorionic twins, although CRL discrepancy happened in the first trimester.