Study Nuchal Translucency And The Way Of Umbilical Cord Attached On The Clinical Value Of Early Screening Of Twin-twin Transfusion Syndrome

Objective:â‘ To discuss the value of nuchal translucency and the way of umbilical cord insertion for predicating twin-twin transfusion syndrome (TTTS) occurs in monochorionic diamniotic (MCDA) twin.â‘¡To investigate the relationship between TTTS severity grade or delivery weeks and the prognosis of perinatal new born.Methods:Totally,282cases of twin pregnant woman were check-ups and delivery from January2010to March2013at the First Affiliateted Hospital of Kunming Medical University. Among them,112cases were MCDA. Select retrospective analysis of their prenatal ultrasound results and post-natal clinical data of76cases. The suspected TTTS were3cases, diagnosed with TTTS were15cases. According to the prenatal ultrasound findings and clinical data of postpartum, pregnant women were divided into two groups, TTTS group has15cases,10cases had NT values,12cases of umbilical cord attached type data, there were7cases of NT value and the umbilical cord insertion mode; the non-TTTS group has58cases,40cases had NT values,46cases of umbilical cord attached type data, there were27cases of NT numerical and umbilical cord attachment style.Results:â‘ In TTTS group, the incidence rate of two fetal NT difference>0.5mm was40%(4/10). In non-TTTS group, the incidence rate of two fetal NT difference>0.5mm was10%(4/40), The difference was statistically significant (P<0.05).â‘¡In TTTS group, the incidence rate of velamentous insertion or on the edge of umbilical cord was66.7%(8/12). In non-TTTS group, the incidence rate of velamentous insertion or on the edge of umbilical cord was28.3%(13/46), The difference was statistically significant (P<0.05); each the TTTS group and the non-TTTS group have a case, which had two the edge or velamentous insertion of umbilical cord of a placenta, no statistically significant differences (P>0.05). In the TTTS group, the incidence of umbilical cord attached is not the same as58.3%(7/12).In the non-TTTS group, the incidence of umbilical cord attached was not the same as26.1%(12/46), The difference was statistically significant (P<0.05); In the TTTS group, only1the recipient had the edge or velamentous umbilical cord insertion, but8the donor has, the difference was statistically significant (P<0.05).â‘¢In15patients with TTTS,5cases delivery before28weeks, the mortality rate was100%. There were4cases delivery between28weeks to34weeks, mortality rate75%.6cases delivery after34weeks, mortality rate25%. The fetal mortality rates of ultrasound grade â… ,â…¡,â…¢,â…£ and â…¤ was0%,50%,75%,72.3%and100%, respectively.Conclusions:1. with the increase of fetal NT difference, the possibility of TTTS occurrence increase, but failed to clearly determine relationship between NT and TTTS.2. The umbilical cord insertion method may be certain value in the prediction of TTTS. In TTTS, the incidence rate of velamentous insertion or on the edge of umbilical cord in the recipients is higher than in the donors.3. The poor prognosis of TTTS, grade of TTTS severity and birth gestational age are important factors to determine the prognosis of perinatal fetus.Diagnosis classification on the bag of ultrasound is higher, birth gestational age is earlier, the perinatal mortality rate is higher.