摘要
目的:探索双绒毛膜双羊膜囊(DCDA)双胎不同分娩方式与围产结局的关系。方法:2012年1月—20l7年1月在本院接受产前超声检查且被追踪到妊娠结局的DCDA双胎孕妇共162例,其中阴道分娩50例,剖宫产112例,比较两种分娩方式的围产结局。结果:(1)阴道分娩组孕周<37周占64.0%,新生儿体重<2500g占65.0%,均高于剖宫产组的45.5%及46.9%(P<0.05);剖宫产组孕周≥37周(54.5%)及新生儿体重(≥2500g,53.1%)高于阴道分娩组(36.0%、35.0%)(P<0.05);(2)剖宫产组子痫前期发生率(20.5%)高于阴道分娩组(6.0%)(P<0.05);(3)两组产后出血率及新生儿死亡发生率比较无差异(P>0.05);(4)两组第一胎新生儿窒息率比较无差异(P>0.05),但阴道分娩组第二胎儿新生儿窒息率(14.0%)高于剖宫产组(3.6%)(P<0.05);第一胎与第二胎分娩间隔时间≤15min者、第二胎儿新生儿窒息率比较无差异(P>0.05),但分娩间隔时间>15min者、第二胎儿新生儿窒息率阴道分娩组(10.0%)高于剖宫产组(0)(P<0.05),阴道分娩组分娩间隔时间>15min者第二胎儿脐动脉pH及BE值均高于分娩间隔时间≤15min组(P<0.05)。结论:第一胎儿为头位的DCDA双胎分娩方式应根据孕周、胎儿估计体重、妊娠并发症等综合分析,重视第二胎儿第二产程处理,阴道分娩两胎儿分娩间隔时间宜在15min以内。
Objective：To explore the association between the mode of delivery and perinatal outcome in dichorionic diamniotic （DCDA） twin pregnancy.Methods：162 patients of DCDA from January 2012 to January 2017 in the first affiliated hospital of Kunming medical university were enrolled and divided into two groups according to the mode of delivery,which included vaginal delivery group （50 cases） and cesarean delivery group （112 cases）.The perinatal outcome was compared between the two groups.Results：（1）The incidence of pregnant week less than 37 weeks and birth weight less than 2500g in vaginal delivery group was significantly higher than that in cesarean delivery group （P ＜0.05）.The incidence of pregnant week more than or equal to 37 weeks and birth weight more than or equal to 2500g in cesarean delivery group were significantly higher than those in vaginal delivery group （P ＜ 0.05）.（2） The incidence of preeclampsia in cesarean delivery group was significantly higher than that in vaginal delivery group （P ＜ 0.05）.（3）There was no significantly difference in postpartum hemorrhage and neonatal mortality rate between the two groups （P＞0.05）.（4） There was no significantly difference in neonatal asphyxia rate of the first fetus between the two groups （P＞0.05）,whereas the neonatal asphyxia rate of the second fetus was significantly higher in vaginal delivery group than that in cesarean delivery group （P ＜ 0.05）.There was no significantly difference in neonatal asphyxia rate of the second fetus when delivery interval less than or equal to 15 minutes between the two groups （P＞0.05）,whereas the neonatal asphyxia rate of the second fetus when delivery interval over 15 minutes was significantly higher in vaginal delivery group than that in cesarean delivery group （P ＜ 0.05）.The pH and base excess （BE） of the second fetus when delivery interval over 15 minutes was significantly higher in vaginal delivery group than that in delivery interval less than o
作者
耿力
杨丽娜
GENG Li;YANG Lina(Department of Obstetrics, The First Affiliated Hospital of Kunming Medical University, Kunming ,65003)
出处
《中国计划生育学杂志》
2018年第5期379-382,共4页
Chinese Journal of Family Planning
基金
云南省卫生厅研究基金(2011WS0040)
关键词
双绒毛膜双羊膜囊双胎
分娩方式
产后出血
新生儿窒息
Dichorionic diamniotic （DCDA） twin pregnancy
Mode of delivery
Postpartum hemorrhage
Neonatal asphyxia
