摘要目的:回顾性分析双胎反向动脉灌注序列征(TRAP)的超声分型，探讨其临床意义。方法:选取2001年1月至2020年1月在湖北省妇幼保健院产前诊断的TRAP 114例，分为5型：半心畸形(Ⅰ型)、有头有躯干型(Ⅱ型)、无头有躯干型(Ⅲ型)、无头无躯干型(Ⅳ型)及不定型(Ⅴ型)；将以上5型分为A(Ⅰ、Ⅱ、Ⅲ型)、B(Ⅳ、Ⅴ型)两组，比较两组间自然妊娠结局。结果:114例TRAP中活产27例(23.7%)，宫内死亡33例(29.0%)，围生期死亡7例(6.1%)，合并心力衰竭引产22例(19.3%)，合并泵血儿畸形引产4例(3.5%)，不合并心力衰竭引产21例(18.4%)。114例TRAP中，Ⅰ型20例(17.5%)，Ⅱ型27例(23.7%)，Ⅲ型48例(42.1%)，Ⅳ型8例(7.0%)，Ⅴ型11例(9.7%)。B组自然妊娠预后优于A组( P＝0.007)。 结论:基于产前超声的诊断，5型TRAP中，Ⅳ型、Ⅴ型临床预后优于Ⅰ型、Ⅱ型、Ⅲ型，产前超声分型对泵血儿的临床预后有一定指导意义。

abstractsObjective:To retrospectively analyze the classification of twin reversed arterial perfusion(TRAP) by prenatal ultrasound diagnosis, and to explore the clinical significance of this classification method.Methods:One hundred and fourteen TRAP cases were selected for prenatal ultrasound examination from January 2001 to January 2020 in Maternal and Child Health Hospital of Hubei Province, and were studied following the classification: hemiacardius(type Ⅰ), anceps trunk(type Ⅱ), acephalus trunk(type Ⅲ), acephalus acormus(type Ⅳ), acardius amorphous(type Ⅴ). Natural pregnancy outcomes were analyzed between group A(type Ⅰ, type Ⅱ, type Ⅲ) and group B(type Ⅳ, type Ⅴ).Results:Among 114 cases of TRAP, 27 cases (23.7%) were live birth, 33 cases (29.0%) were intrauterine death, 7 cases (6.1%) were perinatal death, 22 cases (19.3%) were induced labor complicated with heart failure, 4 cases (3.5%) were induced labor with malformation of pump twin, 21 cases (18.4%) were induced without heart failure of pump twim. Among 114 cases of TRAP, 20 cases (17.5%) were type Ⅰ, 27 cases (23.7%) were type Ⅱ, 48 cases (42.1%) were type Ⅲ, 8 cases (7.0%) were type Ⅳ and 11 cases (9.7%) were type Ⅴ. The prognosis of group B was better than group A during natural pregnancy ( P=0.007). Conclusions:Based on the diagnosis of prenatal ultrasound, the prognosis of type Ⅳ and type Ⅴ TRAP is better than that of type Ⅰ, type Ⅱ and type Ⅲ. The classification by prenatal ultrasound has positive significance for the clinical prognosis of pump twin.