問題詳情

53.美莉產檢時超音波發現，此雙胞胎有兩個羊膜腔，但共用一個胎盤，會有發生雙胞胎間輸血症候群（twin-to-twin transfusion syndrome）的風險，關於雙胞胎間輸血症候群（TTTS），下列敘述何者錯誤？
(A)TTTS發生原因目前認為和共用胎盤，且兩個胎兒間的血管相通（vascular anastomosis）造成血流不平衡有關
(B)recipient的血液容積增加，會造成羊水過多，嚴重時會有心臟衰竭的現象
(C)donor的血液供給recipient，造成donor的血液容積下降，胎兒腎臟灌流（renalperfusion）下降，所以尿量變少，會使羊水過少（oligohydramnios），嚴重時超音波下donor膀胱會看不到，且常被推擠至一角落（stuck twin）
(D)美莉的兩個雙胞胎間如果體重差異超過30%，就可診斷為TTTS

參考答案

答案：D
難度：適中0.47619
統計：A(3),B(1),C(1),D(10),E(0)

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 It is the combination of oligohydramnios and polyhydramnios in a MC twin pair seen by ultrasound that indicates the diagnosis of TTTS.----------------------------------------------------------------------WIKI Quintero StagesA staging system is commonly used to classify the severity of TTTS.[3]Stage I: A small amount of amniotic fluid (oligohydramnios) is found around the donor twin and a large amount of amniotic fluid (polyhydramnios) is found around the recipient twin.Stage II: In addition to the description above, the ultrasound is not able to identify the bladder in the donor twin.Stage ...