摘要
目的:探讨产前超声监测在单绒毛膜双羊膜囊双胎选择性胎儿生长受限中的价值。方法:选取2014年2月-2016年1月本院诊断为单绒毛膜双羊膜囊双胎选择性胎儿70例。按照胎儿生长受限与否分为受限组34例和未受限组36例。对比两组死亡率、并发症发生率。同时对比死亡胎儿与存活胎儿相应的分型以及各项监测指标。结果:受限组死亡率为52.94%(18/34),显著高于未受限组的27.78%(10/36);死亡组Ⅱ型围生儿占比为57.14%(16/28),显著高于存活组的28.57%(12/42);死亡组静脉导管异常、羊水过少、重度s IUGR占比均显著高于存活组,差异均有统计学意义(P<0.05)。经多因素Logistic回归分析,影响围生儿死亡的独立危险因素包括Ⅱ型s IUGR(OR=3.872,P=0.000)、静脉导管异常(OR=4.108,P=0.000)、羊水过少(OR=3.283,P=0.000)、重度s IUGR(OR=6.287,P=0.000)。结论:产前超声监测在单绒毛膜双羊膜囊双胎选择性胎儿生长受限中的应用有利于选择分娩时机,提高围生儿存活率,其中Ⅱ型s IUGR、静脉导管异常、羊水过少、重度s IUGR均可作为临床上判断选择性胎儿生长受限指标。
Objective：To investigate the value of prenatal ultrasound monitoring in the bursa of monochorionic diamniotic twins selective fetal growth restriction.Method：From February 2014 to January 2016,monochorionic diamniotic twins selective fetal disease in our hospital diagnosis of patient of 70 cases.They were divided into restricted group 34 cases,and non-restricted group 36 cases according to fetal growth restriction or not.Mortality,complication rate,the respective type of death and survival fetal,the monitoring index of two groups were compared.Result：The mortality rate was 52.94%（18/34） in the restricted group,which was significantly higher than 27.78%（10/36） of the non-restricted group.The rate of Ⅱ type births of the death group accounted for 57.14%（16/28）,and it was significantly higher than 28.57%（12/42） of the survival group.The rate of venous catheter unusual deaths,oligohydramnios,severe siugr of the death group were significantly higher than those in the survival group,the differences were statistically significant（P〈0.05）.By multivariate Logistic regression analysis,impact peri perinatal deaths were the independent risk factors,including type Ⅱ siugr（OR=3.872,P=0.000）,abnormal venous catheter（OR=4.108,P=0.000）, oligohydramnios（OR=3.283,P=0.000）,severe siugr（OR=6.287,P=0.000）.Conclusion：It is helpful of prenatal ultrasound monitoring in monochorionic diamniotic sac twins selective fetal growth restricted in application to choose the time of delivery,so as to improve the survival rate of perinatal fetuses,which type II SIUGR,abnormal venous catheter,oligohydramnios,severe SIUGR can be used as a index of clinical judgment selective fetal growth restriction.
出处
《中国医学创新》
CAS
2017年第3期115-117,共3页
Medical Innovation of China
关键词
单绒毛膜双羊膜囊双胎
选择性胎儿
生长受限
超声
监测
Monochorionic diamniotic twins pregnancy
Fetal growth restriction
Selectivity
Ultrasound
Monitoring
