单绒毛膜单羊膜囊双胎脐带打结二例

单绒毛膜单羊膜囊（monochorionic monoamnionic,MCMA）单卵双胎是双胎妊娠中极罕见的一种类型,为极高危的双胎妊娠。由于两胎儿共用一个羊膜腔,两胎儿之间无胎膜分隔,因脐带缠绕和打结而发生宫内意外的可能性较大。对于双胎妊娠的孕妇应尽早明确其绒毛膜性质,一旦诊断为MCMA双胎,应提高警惕,在指南推荐的妊娠周数及时终止妊娠,改善母儿结局。回顾性报道山西省妇幼保健院2例MCMA双胎妊娠脐带形成真结并成功分娩的病例,以提高产科医师对早期诊断并分辨双胎绒毛膜性的意识,当诊断为MCMA双胎时,要特别关注脐带形态学及结构学上的异常,并加强对MCMA双胎妊娠孕妇的产前管理。

Umbilical Cord Knot in Monochorionic Monoamnionic: Two Cases Report

Monochorionic monoamnionic (MCMA) monozygotic twin is a very rare type of twin pregnancy, which is extremely high-risk twin pregnancy. Because the two fetuses share the same amniotic cavity and there is no fetal membrane separation between the two fetuses, there is a greater possibility of intrauterine accidents due to umbilical cord entanglement and knot. For pregnant women with twin pregnancies should be clear as soon as possible its chorionic properties. Once diagnosed as MCMA twins, vigilance should be raised and termination of pregnancy in the guidelines recommend gestational weeks to improve maternal and infant outcomes. This paper retrospectively reports two cases of monochorionic monoamnionic twins pregnancy with true umbilical knot and successful delivery in Shanxi Maternal and Child Health Hospital, to improve obstetricians′ awareness of early diagnosis and differentiation of twin chorionic properties. Special attention should be paid to the abnormality of umbilical cord morphology and structure when diagnosed as monochorionic monoamnionic twins, prenatal management of monochorionic monoamnionic twins pregnancies should be strengthened.