产前超声在双胎反向动脉灌注综合征诊疗中的应用

目的 探讨产前超声在双胎反向动脉灌注(TRAP)综合征诊疗中的临床价值.方法 回顾性分析我院产前超声诊断的5例TRAP超声图像、临床资料及妊娠结局,总结TRAP声像学特点.结果 5例TRAP初次确诊孕周为13～28周,均于产后得到证实.彩色多普勒超声检查显示无心畸胎血液循环呈现反向动脉灌注的特点.5例中2例引产;1例流产;1例超声引导下接受无心畸胎减胎术,妊娠至37周分娩;1例在超声密切监测下妊娠至32+4周分娩,新生儿结局良好.结论 产前超声检查对TRAP的早期诊断、预后判断、治疗方案和分娩时机的选择有重要应用价值.

Prenatal ultrasound application in diagnosis and treatment of twin reverse arterial perfusion syndrome

Objective To investigate the value of prenatal ultrasound in diagnosis and treatment of twin reverse arterial perfusion (TRAP) syndrome. Methods A retrospective study was performed in 5 TRAP cases, including ultrasound images, clinical data and pregnancy outcomes. The sonographic characteristics were summarized. Results Five TRAP cases were diagnosed during 13 to 28 weeks' gestation and confirmed after birth. Color Doppler unltrasonography revealed retrograde umbilical artery perfusion towards acardiac twin. Two of 5 cases ended up in induced abortion, 1 in spontaneous abortion, 1 was delivered at 37 weeks' gestation after ultrasound-guided feticide of the acardiac twin and 1 was monitored closely with ultrasound and delivered alive at 32~(+4) weeks' gestation. Conclusion Prenatal ultrasonography has great applicative value for TRAP syndrome in early diagnosis, choosing optimal treatment and prognosis assessment.