頁籤選單縮合
題名 | Acardiac Acephalus: A Case Report and Implications on Expectant Management=雙胞胎併一無心畸胎:一例報告及保守治療之意義 |
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作 者 | 劉錦成; 張舜智; 陳芳萍; 宋永魁; | 書刊名 | 長庚醫學 |
卷期 | 22:2 1999.06[民88.06] |
頁次 | 頁334-338 |
分類號 | 417.343 |
關鍵詞 | 雙胞胎併無心畸胎; 單絨毛膜雙胞胎妊娠; Acardiac parabiotics twin; Monochorionic twin pregnancy; |
語文 | 英文(English) |
中文摘要 | 雙胞胎併無心畸胎(acardiac parabiotic twin)為一罕見之病例,主要肇因於一 單絨毛膜雙胞胎兒血管間大量及直接交通所致。畸胎之胎兒無生存之機會而供血之一方則因 早產及心臟衰竭使得週產期之死亡率高達 50 %。一旦診斷確立,以各種方式阻斷胎兒之間 之血流將是確保正常胎兒有較好生存機會之方法,但若無一詳細之術前評估而冒然採取侵襲 性之手術將對正常胎兒有不利之影響。本案例為一 21 歲,單胎次,妊娠 28 週產婦合併雙 胞胎無心畸胎,臨床上以密集監測正常胎兒之方式處理,並回顧文獻之病例以探討其最合適 之處理方法。 |
英文摘要 | Acardiac acephalus is a rare occurrence resulting from extensive anastomoses between the vessels of the monochorionic twins which invariably leads to death of the "perfused" twin and an estimated 50% perinatal mortality rate in the "pump" twin, due mainly to premature delivery or congestive heart failure. Once diagnosis has been documented, blocking the vascular flows between the twins has been the prinicple goal of treatment with the assumption that a more favorable chance of survival in the pump twin can be achieved. However, hasty surgical intervention without a well-designed preoperative evaluation may result in unfavorable outcomes. A 21-year-old nullipara was found to carry an acardiac parabiotic twin in a monochorionic twin pregnancy at 28 weeks of gestation and was referred to us from a local clinic. Expectant management based on the close monitoring of the well-being of the healthy co-twin is presented in this article along with review of published works on the management of this rare condition. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。