- 作者：Eugenia Antolí ; n Alvarado ; eantolin.hgugm@salud.madrid.org ; eugenia-antolin@terra.es ; Ricardo Pé ; rez Ferná ; ndez Pacheco ; Francisco Gá ; mez Alderete ; Juá ; n Antonio de Leó ; n Luí ; s ; Á ; ngel Aguaró ; n de la Cruz ; Luí ; s Ortiz Quintana
- 关键词：Selective termination ; Dichorionic twins ; Discordant congenital defect
- 刊名：European Journal of Obstetrics and Gynecology and Reproductive Biology
- 出版年：2012
- 期刊代码：92_03012115
- 类别：med
- 出版时间：March, 2012
- 卷：161
- 期：1
- 页码：8-11
- 文件大小：211 K
Objective
To evaluate the perinatal outcome of selective termination in dichorionic twins discordant for congenital defect, performed at the Hospital General Universitario Gregorio Mara帽on.Study design
Twenty-eight dichorionic twins with an anomalous fetus were included from May 2008 to February 2011. Intracardiac KCl (1-2 ml; 15 mEq/ml) under ultrasonographic guidance was used in all procedures. Congenital defect, gestational age at the procedure, incidence and perinatal outcome were retrieved.
Results
Selective termination was performed in 14 (50%) cases of structural defects with normal karyotype and in 14 (50%) cases of chromosomal abnormality, 13 of them (92.8%) trisomy 21. Median gestational age at the procedure was 17.8 weeks (range 14.5-24; SD 2.3), and 12 (42.8%) were performed before 18 weeks. The presenting fetus was terminated in 11 cases (39.3%). Selective termination was followed by the subsequent delivery of a viable infant in 27 out of 28 cases (96.4%). Fetal loss before 24 weeks occurred in 1 case (3.6%). Median gestational age at delivery was 38 weeks (range 24.1-40.1; SD 3.8). Twenty-four (88.9%) were delivered >34 weeks and 1 (3.7%) before 28 weeks.
Conclusion
Selective termination in dichorionic twins discordant for congenital defect is a safe procedure with low risk of unintended fetal loss. This option is a reasonable alternative to expectant management or termination of the whole pregnancy.