臨床婦人科産科67巻12号

2013年12月発行

今月の臨床 多胎妊娠管理の最新スタンダード─ガイドラインを踏まえて 多胎妊娠の妊娠・分娩管理

1．MD双胎の管理

著者： 村越毅¹

所属機関： ¹聖隷浜松病院総合周産期母子医療センター周産期科

ページ範囲：P.1219 - P.1227

●膜性診断は双胎妊娠管理の基本であり，妊娠初期に確実に行うことが大切である．膜性不明の場合はよりリスクの高い1絨毛膜双胎として管理する．

●MD双胎の管理は最低2週間ごとの推定体重と羊水量測定を行う．推定体重や羊水量に差を認める場合は，TTTSに代表される特徴的な疾患を念頭におき精査する．

●胎児血流計測（臍帯動脈，臍帯静脈，静脈管，中大脳動脈など）はMD双胎管理，特に精密検査および胎児評価にきわめて有用なツールである．

参考文献

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