[Perinatal management of twins with discordant congenital defects].
キーワード
概要
OBJECTIVE
To review the outcomes of perinatal management of twins with discordant congenital defects.
METHODS
We retrospectively examined the cases of twins with discordant congenital defects treated in the West China Second University Hospital from December 2011 to December 2013.
RESULTS
There were 26 cases of twins (14 dichorionic and 12 monochorionic) with one anomalous fetus. Of those twins, 16 were conceived by nature and 10 by in vitro fertilization and embryo tansfer (IVF-ET). Counselling services were offered to the parents by a multidisciplinary team about options of pregnancy. Termination of pregnancy was chosen on three monochorionic twins. Twelve pairs of twin were delivered at 26(+3)-37(+6) weeks gestation. One pair ended with neonatal death, and another one with gastroschisis was given intrapartum fetal operation. Selective termination was chosen on 11 cases using intracardiac injection of potassium chloride under ultrasonographic guidance (9 cases) or bipolar cord coagulation (2 cases). This resulted in ten live births delivered at 25(+5)-38(+4) gustation and one neonatal death.
CONCLUSIONS
Early diagnosis of twins with discordant congenital defects is important. Multidisciplinary counselling services to parents are recommended for determination of options. Intensive prenatal care is essential in management of twins with discordant congenital defects.
