未经证实:大动脉脱位(D-TGA)是一种罕见的先天性心脏病,因为它只影响0.02-0.05%的活产。它是继法洛四联症之后第二常见的紫癜性心脏病。它具有男性优势。胎儿超声心动图是胎儿D-TGA产前诊断的最佳方法。在双胞胎怀孕中,胎儿D-TGA在一个双胞胎中非常罕见,尤其是在单绒毛膜-双胎妊娠中。在这里,我们报告了2018年1月至2021年6月在2例双绒毛膜-双胎妊娠和1例单绒毛膜-双胎妊娠中的1例D-TGA。
未经证实:在妊娠中期通过胎儿超声心动图诊断为双胎D-TGA,在所有三个病例中,双胞胎都是正常的。一个多学科团队提供了关于D-TGA双胞胎和共同双胞胎的广泛咨询,并提供了适当的围产期管理。在病例1、2和3中,母亲在37周+2天进行剖宫产,34周+5天,36周+1天,分别。在病例1中,涉及一名出生体重为2,410g的女性D-TGA新生儿,出生后20小时进行紧急房间隔造口术,新生儿出生后24天接受心房开关手术(ASO)。在案例2中,涉及出生体重为2,380克的男性D-TGA新生儿,出生后24天进行ASO。在病例3中,涉及一名出生体重为2,240克的女性D-TGA新生儿,出生后19天进行ASO,4天后进行胸骨延迟闭合。所有6名婴儿在随访期间均表现出正常发育。
UNASSIGNED:对双胎妊娠的一个胎儿进行早期产前诊断D-TGA非常重要。多学科小组应在怀孕和围产期对D-TGA双胞胎和双胞胎进行个人评估和综合管理。出生后,必要时,应进行D-TGA双胞胎的动脉导管延迟闭合,并应考虑动脉转换手术的个体化时机.
UNASSIGNED: Dextro-transposition of the great arteries (D-TGA) is a rare congenital heart disease, as it affects only 0.02-0.05% of live births. It is the second most common cyanotic heart disease following Tetralogy of Fallot. It has a male predominance. Fetal echocardiography is an optimal method for prenatal diagnosis of fetal D-TGA. In twin pregnancies, fetal D-TGA in one twin is very rare, especially in monochorionic-diamniotic twin pregnancies. Herein, we report a case of D-TGA in one twin in two dichorionic-diamniotic twin pregnancies and one monochorionic-diamniotic twin pregnancy from January 2018 to June 2021.
UNASSIGNED: One twin with D-TGA was diagnosed by fetal echocardiography in the second trimester, and the co-twin was normal in all three cases. A multidisciplinary team provided extensive counseling regarding the D-TGA twin and the co-twin, and adequate perinatal management was provided. In cases 1, 2, and 3, the mothers underwent cesarean sections at 37 weeks + 2 days, 34 weeks + 5 days, and 36 weeks + 1 day, respectively. In case 1, which involved a female D-TGA neonate with birth weight 2,410 g, an emergent atrial septostomy was performed at 20 h after birth, and the neonate underwent atrial switch operation (ASO) 24 days after birth. In case 2, involving a male D-TGA neonate with a birth weight of 2,380 g, ASO was performed 24 days after birth. In case 3, involving a female D-TGA neonate with birth weight 2,240 g, ASO was performed 19 days after birth and delayed sternal closure was performed 4 days later. All six infants showed normal development during follow-up.
UNASSIGNED: Early antenatal diagnosis of D-TGA in one fetus of a twin pregnancy is significantly important. A multidisciplinary team should carry individual evaluation and integrated management of the D-TGA twin and co-twin during the pregnancy and perinatal period. After birth, delayed ductus arteriosus closure in the D-TGA twins should be performed when necessary and individualized timings for arterial switch operation should be considered.