双胎児における未熟児網膜症の発症・進行要因の検討

Factors for onset and progression of retinopathy of prematurity in twins

　出生体重1,500g未満の極小未熟児を少なくとも1児を含む7組15児の双胎と品胎について，未熟児網膜症の発症と進行因子を検討した。未熟児網膜症は在胎週数が短く，出生体重が小さいほど発症頻度が高かった。出生体重の大きい児に発症ないし重症である双胎児では，出生直後の数日間に動脈血二酸化炭素分圧が低値であり，pHが高い傾向があった。多胎児では未熟児網膜症の可能性を考慮して，妊娠中の早産予防を含めた母体管理と出生後の管理が必要であること，双胎児間で胎内発育の不均衡がある場合には，生後の全身管理と発症進行因子についての注意が望ましいことが結論された。

We evaluated potential factors involved in the onset and progression of retinopathy of prematu-rity (ROP) in 6 pairs of twins and 1 triplet in whom at least one infant weighed 1,500 g or less at birth.

The incidence of ROP was in inverse proportionto the gestational age and the birthweight. The series included 2 pairs in which a member with a higher birthweight manifested ROP while the other member with a lower birthweight was free of ROP. There were 4 cases with ROP in the series who showed low PaCO₂ and high pH value during the neonatal period. We advocate proper prophylactic and therapeutic approach to twins and triplets because of inherent higher risk of ROP.