国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2015, Vol. 34 ›› Issue (2): 156-159.

• 综述 • 上一篇    下一篇

单绒毛膜双羊膜囊双胎减胎的研究进展

莫莉菁，赵军招   

  1. 325000 温州医科大学附属第一医院生殖中心
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-03-15 发布日期:2015-03-15
  • 通讯作者: 莫莉菁

Research Progress on Multifetal Reduction for Monochorionic Diamniotic Twin

MO Li-jing，ZHAO Jun-zhao   

  1. Reproductive Medical Center of the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-03-15 Online:2015-03-15
  • Contact: MO Li-jing

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摘要： 与辅助生殖技术（ART）相关的单卵双胎（MZT）的发生率不断升高。双胎妊娠绒毛膜性的判定可对其风险进行分层。单绒毛膜双羊膜囊（MCDA）双胎围生期具有高发病率和死亡率，其各种减胎方法各有利弊。传统的阴道超声引导下的胚胎组织穿刺抽吸术具有局限性，现主要采用血管闭塞技术用于对MCDA双胎进行选择性减胎，比如脐带双极电凝术和射频消融术等。减胎术的并发症主要有未足月胎膜早破（PPROM）和早产，但有关MCDA的各种减胎方法的时机、适应证及预后等尚未形成统一的标准，故对于减胎术后的新生儿必须进行长期的随访。

关键词: 生殖技术, 辅助, 双生, 单卵, 绒毛膜, 妊娠减少, 多胎, 预后

Abstract: The incidence of monozygotic twining （MZT） is increased in those women treated with assisted reproductive technology（ART）. Determining monochorionic or diachorionic twin can be used as a factor for the risk stratification. The perinatal morbidity and mortality of monochorionic diamniotic（MCDA） twin are high. There are several methods of multifetal reduction for MCDA twin with respective merits and demerits. The traditional transvaginal ultrasoundguided puncture and aspiration of embryonic tissue has its demerits. The vessel-occluded techniques have been generally used in the selective reduction for MCDA twin，including the bipolar cord coagulation（BCO） and the radiofrequency ablation（RFA），etc. Premature rupture of membrane（PPROM） and premature delivery are the main complications of selective reduction. However，there is not the standard guideline on the time，method，prognosis and indication of the selective reduction for MCDA twin. It is necessary to do long-term follow-up for those living infants after the multifetal reduction.

Key words: Reproductive techniques, assisted, Twins, monozygotic, Chorion, Pregnancy reduction, multifetal, Prognosis