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臨床婦人科産科67巻12号

2013年12月発行

文献概要

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

2.MM双胎の管理

著者: 兵藤博信1

所属機関: 1聖路加国際病院女性総合診療部

ページ範囲:P.1230 - P.1235

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●MM双胎は,双胎のなかでもさまざまな点でリスクが大きいが,生児を期待できる見込みは十分にある.

●超音波で臍帯相互巻絡の状態が把握できるが,予後との関連は薄く,また,TTTSはMD双胎より少ない.

●24~26週からの管理入院と厳重監視が現実的な選択であるが,適切な分娩時期は議論の余地がある.

参考文献

1) Roque H, Lockwood CJ : Monoamniotic twin pregnancy. UpToDate, Wolters Kluwer, Waltham, MA, USA, accessed on June 16, 2013
2) Hack KE, Derks JB, Schaap AH, et al : Perinatal outcome of Monoamniotic twin pregnancies. Obstet Gynecol 113 : 353─360, 2009
3) 日本産科婦人科学会,日本産婦人科医会(編) : 産婦人科診療ガイドライン─産科編2011.pp288─290,日本産科婦人科学会,2011
4) James WH : A further note on the sex ratio of monoamniotic twins. Ann Hum Biol 18 : 471─474, 1991
5) Chitnis S, Derom C, Vlietinck R, et al : X chromosome-inactivation patterns confirm the late timing ofmonoamniotic-MZ twinning. Am J Hum Genet 65 : 570─571, 1999
6) Slotnick RN, Ortega JE : Monoamniotic twinning and zona manipulation : a survey of US IVF centers correlating zona manipulation procedures and high-risk twinning frequency. J Assist Reprod Genet 13 : 381─385, 1996
7) Corbett SL, Shmorgun D : Yolk sac number does not predict reliably amnionicity in monochorionic twin pregnancies : a case of a monochorionic monoamniotic twin pregnancy with two distinct yolk sacs on early first-trimester ultrasound. Ultrasound Obstet Gynecol 39 : 607─608, 2012
8) Heyborne KD, Porreco RP, Garite TJ, et al : Improved perinatal survival of monoamniotic twins with intensive inpatient monitoring. Am J Obstet Gynecol 192 : 96─101, 2005
9) Umur A, van Gemert MJC, Nikkels PGJ : Monoamniotic-versus diamniotic-monochorionic twin placentas : Anastomoses and twin-twin transfusion syndrome. Am J Obstet Gynecol 189 : 1325─1329, 2003
10) Hack KEA, van Gemert MJC, Lopriore E, et al : Placental characteristics of monoamniotic twin pregnancies in relation to perinatal outcome. Placenta 30 : 62─65, 2009
11) Frisch L, Groisman G, Hallak M : First trimester diagnosis of forked cord in monoamniotic twin pregnancy. Placenta 32 : 1057─1059, 2011
12) Rossi AC, Prefumo F : Impact of cord entanglement on perinatal outcome of monoamniotic twins : a systematic review of the literature. Ultrasound Obstet Gynecol 41 : 131─135, 2013
13) Lewi L : Opinion : Cord entanglement in monoamniotic twins : does it really matter? Ultrasound Obstet Gynecol 35 : 139─141, 2010
14) Baxi LV, Walsh CA : Monoamniotic twins in contemporary practice : a single-center study of perinatal outcomes. J Matern Fetal Neonatal Med 23 : 506─510, 2010
15) Asada K, Horikoshi T, Nagamatsu T, et al : The optimal timing of delivery of monoamniotic twin pregnancies. The 1st Taiwan-Korea-Japan Symposium in Maternal-Fetal Medicine. August, 2011
16) Morikawa M, Yamada T, Yamada T, et al : Prospective risk of intrauterine fetal death in monoamniotic twin pregnancies. Twin Res Hum Genet 15 : 522─526, 2012

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1294

印刷版ISSN:0386-9865

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