臨床婦人科産科74巻1号

2020年01月発行

合併増大号　今月の臨床 周産期超音波検査バイブル―エキスパートに学ぶ技術と知識のエッセンス 胎児疾患編

一絨毛膜双胎の疾患

著者： 山本亮¹

所属機関： ¹大阪母子医療センター産科

ページ範囲：P.177 - P.182

●一絨毛膜双胎特有の疾患はいずれも胎児治療の適応となる可能性があり，適切な時期に超音波断層法による診断が成されることが望ましい．

●TTTSが疑われる症例の羊水量評価においては，羊水過少の偽陰性に特に留意する．

●TAPSにおける胎盤輝度差は，カラードプラ法によらないTAPS診断の一助となる可能性がある．

参考文献

1）Quintero RA, et al : The cocoon sign : a potential sonographic pitfall in the diagnosis of twin-twin transfusion syndrome. Ultrasound Obstet Gynecol 23 : 38-41, 2004

2）Quintero RA, et al : Staging of twin-twin transfusion syndrome. J Perinatol 19 : 550-555, 1999

3）Hayashi S, et al : Manifestation of mirror syndrome after fetoscopic laser photocoagulation in severe twin-twin transfusion syndrome. Fetal Diagn Ther 21 : 51-54, 2006

4）Ishii K, et al : Perinatal outcome of monochorionic twins with selective intrauterine growth restriction and different types of umbilical artery Doppler under expectant management. Fetal Diagn Ther 26 : 157-161, 2009

5）Gratacos E, et al : A classification system for selective intrauterine growth restriction in monochorionic pregnancies according to umbilical artery Doppler flow in the smaller twin. Ultrasound Obstet Gynecol 30 : 28-34, 2007

6）Lopriore E, et al : Placental characteristics in monochorionic twins with and without twin anemia-polycythemia sequence. Obstet Gynecol 112 : 753-758, 2008

7）Slaghekke F, et al : Laser surgery as a management option for twin anemia-polycythemia sequence. Ultrasound Obstet Gynecol 44 : 304-310, 2014

8）Slaghekke F, et al : Twin anemia-polycythemia sequence : diagnostic criteria, classification, perinatal management and outcome. Fetal Diagn Ther 27 : 181-190, 2010

9）Tollenaar LSA, et al : Improved prediction of twin anemia-polycythemia sequence by delta middle cerebral artery peak systolic velocity : new antenatal classification system. Ultrasound Obstet Gynecol 53 : 788-793, 2019

10）Bamberg C, et al : Quantified discordant placental echogenicity in twin anemia-polycythemia sequence（TAPS）and middle cerebral artery peak systolic velocity. Ultrasound Obstet Gynecol 52 : 373-377, 2018

11）Sugibayashi R, et al : Forty cases of twin reversed arterial perfusion sequence treated with radio frequency ablation using the multistep coagulation method : a single-center experience. Prenat Diagn 36 : 437-443, 2016