The pregnancy and long-term neurodevelopmental outcome of monochorionic diamniotic twin gestations: a multicenter prospective cohort study from the first trimester onward

被引：109

作者：

Ortibus, Els ^{[1
]}

Lopriore, Enrico ^{[3
]}

Deprest, Jan ^{[2
]}

Vandenbussche, Frank P. ^{[4
]}

Walther, Frans J. ^{[3
]}

Diemert, Anke ^{[5
]}

Hecher, Kurt ^{[5
]}

Lagae, Lieven ^{[1
]}

De Cock, Paul ^{[1
]}

Lewi, Paul J. ^{[2
]}

Lewi, Liesbeth ^{[2
]}

机构：

[1] Univ Hosp, Dept Pediat, Louvain, Belgium

[2] Univ Hosp, Dept Obstet & Gynecol, Louvain, Belgium

[3] Leiden Univ, Dept Pediat, Med Ctr, Leiden, Netherlands

[4] Leiden Univ, Dept Obstet & Gynecol, Med Ctr, Leiden, Netherlands

[5] Univ Klinikum Hamburg Eppendorf, Dept Obstet & Gynecol, Hamburg, Germany

来源：

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY | 2009年 / 200卷 / 05期

关键词：

cerebral palsy; growth; monochorionic twin pregnancy; neurodevelopmental outcome; twin-to-twin transfusion syndrome; TRANSFUSION SYNDROME; PRETERM TWINS; LASER-SURGERY; CHORIONICITY; GROWTH; RISK; MORTALITY; FLOW;

D O I：

10.1016/j.ajog.2009.01.048

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

OBJECTIVES: We sought to document the pregnancy and neurodevelopmental outcome in monochorionic diamniotic twin pregnancies and to identify risk factors for death and impairment. STUDY DESIGN: We conducted a prospective cohort study of 136 monochorionic twins followed up from the first trimester until infancy. RESULTS: A total of 122 (90%) pregnancies resulted in 2 survivors, 6 (4%) in 1 survivor and 8 (6%) in no survivor. In all, 230 (92%) of 250 surviving infants were assessed at a mean age of 24 months. Neurodevelopmental impairment was present in 22 (10%) infants. Death or impairment of 1 or both infants occurred in 28 (22%) of 126 pregnancies. Twin-to-twin transfusion syndrome and assisted conception increased the risk of both death and impairment, whereas early-onset discordant growth only increased the risk of death. CONCLUSION: The mortality in this prospective series was 8% and neurodevelopmental impairment occurred in 10% of infants.

引用

页码：494.e1 / 494.e8

页数：8

共 38 条

[1] Twin chorionicity and the risk of adverse perinatal outcome [J].

Acosta-Rojas, R. ;

Becker, J. ;

Munoz-Abellana, B. ;

Ruiz, C. ;

Carreras, E. ;

Gratacos, E. .

INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, 2007, 96 (02) :98-102

[2] Prevalence of cranial scan abnormalities in preterm twins in relation to chorionicity and discordant birth weight [J].

Adegbite, AL ;

Castille, S ;

Ward, S ;

Bajoria, R .

EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 2005, 119 (01) :47-55

[3] Neuromorbidity in preterm twins in relation to chorionicity and discordant birth weight [J].

Adegbite, AL ;

Castille, S ;

Ward, S ;

Bajoria, R .

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2004, 190 (01) :156-163

[4]

[Anonymous], 1998, SNIJDERS OOMEN NIET

[5]

[Anonymous], 2006, Bayley Scales of Infant and Toddler Development

[6]

BAYLEY N, 1993, DSD, P2

[7]

Brouwer SI, 2006, TWIN RES HUM GENET, V9, P424, DOI 10.1375/183242706777591191

[8] Surveillance of cerebral palsy in Europe:: a collaboration of cerebral palsy surveys and registers [J].

Cans, C ;

Guillem, P ;

Baille, F ;

Arnaud, C ;

Chalmers, J ;

Cussen, G ;

McManus, V ;

Parkes, J ;

Dolk, H ;

Hagberg, G ;

Hagberg, B ;

Hensey, O ;

Dowding, V ;

Jarvis, S ;

Colver, A ;

Johnson, A ;

Surmann, G ;

Krägeloh-Mann, I ;

Michaelis, R ;

Pharoah, P ;

Platt, MJ ;

Topp, M ;

Udall, P ;

Torrioli, MG ;

Miceli, M ;

Wichers, M ;

van Nieuwenhuizen, O .

DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY, 2000, 42 (12) :816-824

[9]

Carroll SGM, 2002, BJOG-INT J OBSTET GY, V109, P182

[10] Frequency of a monochorionic pair in multiple gestations - Relationship to mode of conception [J].

Chow, JS ;

Benson, CB ;

Racowsky, C ;

Doubilet, PM ;

Ginsburg, E .

JOURNAL OF ULTRASOUND IN MEDICINE, 2001, 20 (07) :757-760

← 1 2 3 4 →