쌍태임신시 태반유형 및 제대부착형태가 성장 불일치에 미치는 영향에 관한 연구 = Influence of placentation and abnormal cord insertion on discordant growth in twin gestation

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

Object : The purpose of the study is to determine whether the type of placentation and abnormal cord insertion can affect discordant growth in twin gestation. Materials and methods : We investigated 422 sets of structually normal twin delivered at our twin clinic after 26 weeks of gestation from 1995-1997. All cases of placenta were examined for pathologic evaluation during the study periods. The type of placentation was divided into four groups: monochorionic monoamniotic placenta (n=4); monochorionic diamniotic placenta (n=62); dichorionic diamniotic fused placenta (n=163); dichorionic diamniotic separate placenta(n=193). Cord insertion was also divided into three groups: both side abnormal insertion (n=17); either side abnormal insertion (n=101); both side normal insertion (n=304). Intertwin weight discordancy was classified as mild form (15-25%) and severe form (>25%) by the degree of the discrepancy. Results : The results were as follows; 1. Of these 422 twin sets, 132 (31%) consisted of twin discordancy in weight by 15% or greater (mild form 19%, severe form 12%). 2. There are no significant difference in the frequencies of discordancy between MC twins and DC twins (31.8% vs 31.2%, p=0.97). 3. The prevalence of abnormal cord insertion was 16% and much more frequent in MC placenta than DC placenta (26.5% vs 14%, p=0.001). 4. Although mean gestational age at delivery and mean birth weight were significantly lower in either side abnormal cord insertion group than both side normal cord insertion group (35.7 vs 36.7weeks, p=0.004 : 2317 vs 2475gm, p=0.01), no difference in the frequency of discordancy was observed in these two groups (37.6% vs 29%, p=0.1). Conclusion : The type of placentation and/or abnormal cord insertion were not revealed to affect discordant growth in twin gestation.