射频消融减胎术在单绒三胎妊娠中的应用分析

Application analysis of radiofrequency ablation for monochorionic triplet pregnancy

摘要:

三胎妊娠根据绒毛膜性羊膜性可分为多种类型，其中双绒毛膜三羊膜囊（dichorionic triamniotic，DCTA）三胎及单绒毛膜三羊膜囊（monochorionic triamniotic，MCTA）三胎因存在单绒多胎成分，既存在多胎妊娠相关风险，亦存在单绒双胎并发症发生风险，多胎妊娠减胎术能有效改善妊娠结局，其中射频消融减胎术（radiofrequency ablation，RFA）是最常用的减胎方式。目前对包含单绒毛膜双胎及三胎成分的三胎妊娠行射频消融减胎术的临床报道较少。本研究通过对既往病例报道的回顾，总结射频消融减胎术在DCTA和MCTA三胎妊娠减胎中的安全性、有效性问题，以及减胎时机和减胎指征对妊娠结局的影响，为临床咨询提供指导。

Abstract:

Triplet pregnancies can be divided into various types based on chorionic and amniotic character. Among them， dichorionic triamniotic（DCTA） triplet and monochorionic triamniotic（MCTA） pregnancies have the risk of multiple pregnancies and complications of monochorionic twins due to its monochorionic part. Multifetal pregnancy reduction can improve pregnancy outcomes effectively，and radiofrequency ablation（RFA） is the most commonly performed method. At present，there are few clinical reports on RFA for monochorionic triplet pregnancies and dichorionic triplet pregnancies. This study，through the review of previous studies，has summarized the safety and effectiveness of RFA for triplet pregnancy reduction of DCTA and MCTA，as well as the influence of the timing and indication of reduction on pregnancy outcomes， so as to provide guidance for clinical consultation.