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最近用多普勒血流分析,产前证实了无心畸胎在双胎中的循环模式。现报告3例产前诊断经验。病例1 29岁,G_2P_1。于17孕周时证实双羊膜腔双胎,一为无心无头胎儿,一为正常胎儿。前者有一头颅痕迹,上肢发育不全和相对正常下肢,脊柱发育不良,无任何心脏结构,有两条脐血管。双胎的正常儿脐动脉收缩期与舒张期末比率(S/D)为3.6。多普勒分析证实无心双胎中反向的预期循环模式:动脉波出现在血液进入无心胎儿的血管。母亲口服地高辛0.25mg 2次/日×3,以后维持量0.25mg/日。每周行B超及多普勒血流检查。孕26周后每两周行生物物理相观察,超声扫描和多普勒血流分析。正常胎儿未发现异常。但无心胎儿水肿加重。至孕32周时正常儿非应激试验无反应,缺乏呼吸运动,心脏肥大,于是经剖宫产获正常男婴体
Recent analysis of Doppler flow, prenatal confirmation of unnuclear teratogenesis in twins in the cycle mode. Now report 3 cases of prenatal diagnosis experience. Case 1 29 years old, G_2P_1. Confirmed double amniotic twins at 17 weeks of gestation, one for the unintentional headless fetus, one for the normal fetus. The former has a cranial mark, upper limb hypoplasia and relatively normal lower extremities, spinal dysplasia, without any cardiac structure, there are two umbilical blood vessels. The normal twin umbilical artery systolic and diastolic end-systolic (S / D) ratio was 3.6. Doppler analysis confirmed the reverse expected circulation pattern in unlabelled twins: arterial waves appeared in the bloodstream into unintentional fetal blood vessels. Mother oral digoxin 0.25mg 2 times / day × 3, after the amount of maintenance 0.25mg / day. B-line ultrasound and Doppler blood flow examination every week. Biweekly biopsies, sonography and Doppler flow analysis were performed biweekly after 26 weeks gestation. Normal fetus found no abnormalities. But no heart fetal edema aggravated. 32 weeks pregnant normal non-stress test non-response, lack of respiratory exercise, cardiac hypertrophy, so by cesarean section was normal male baby