Objective To investigate the clinical significance of prenatal ultrasound parameters in predicting perinatal death in monochorionic diamniotic (MCDA) twin with selective intrauterine growth restriction (sIUGR). Methods 31 cases of MCDA twins with sIUGR who delivered between March 2010 and February 2012 in our hospital were recruited for the study. Cases were categorized in to sIUGR type I , II and III according to the different Doppler patterns of end dias-tolic flow velocity ( EDFV) of the umbilical artery. After diagnosing sIUGR, fetal growth, amniotic fluid, and the EDFV were monitored with ultrasound and Doppler for each case. Results The perinatal death rate was significantly higher in cases with type II Doppler pattern compared with cases with type I pattern (P < 0. 05 ) , and was significantly higher in cases with severe IUGR than cases without (P < 0. 01) . Compared with cases with normal amniotic fluid, cases with oligo-hydramnios had significantly higher perinatal death (P < 0. 05). Conclusion Type II Doppler pattern of the umbilical artery and sever IUGR are the risk factors of perinatal death in MCDA cases with sIUGR.%目的 探讨超声下单绒毛膜双羊膜囊双胎选择性宫内生长受限围生儿死亡高危因素.方法 选择2010年3月至2012年2月在暨南大学第二临床医学院产科分娩的31例单绒毛膜双羊膜囊双胎选择性宫内生长受限孕妇,定期采用超声检查进行胎儿体重估测以及羊水测定,并根据脐动脉舒张期血流频谱分为Ⅰ型、Ⅱ型及Ⅲ型,研究各超声指标与围生儿死亡的关系.结果 Ⅱ型围生儿病死率明显高于Ⅰ型,差异有统计学意义(P＜0.05)；出现重度宫内生长受限者其围生儿病死率明显高于无重度宫内生长受限者(P＜0.01)；羊水过少组与非羊水过少组比较,围生儿病死率差异有统计学意义(P＜0.05).结论 Ⅱ型和出现重度宫内生长受限是单绒毛膜双羊膜囊双胎选择性宫内生长受限围生儿死亡的高危因素.
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