摘要
目的 比较含单绒毛膜双胎的三胎妊娠孕妇行单绒毛膜双胎1胎或2胎减灭术的临床结局,探讨多胎妊娠减胎术的效果。方法 含单绒毛膜双胎的三胎妊娠孕妇170例,均于孕7~9周行经阴道超声引导下胚胎抽吸术减胎。151例减灭单绒毛膜双胎中1胎,术后3 d复查超声提示双胎存活71例,80例单胎存活者均为单绒毛膜单胎;19例减灭单绒毛膜双胎2胎,术后3 d复查超声提示单绒毛膜单胎均存活。以双胎存活71例为双胎组,单胎存活99例为单胎组,比较2组年龄、体质量指数、孕次、术前流产次数等临床资料;比较2组孕期流产及活产情况,分娩孕周,妊娠期并发症发生率,足月产、极早产和早产率,新生儿体质量、NICU治疗率。结果 2组年龄、体质量指数、孕次、术前流产次数及减胎孕周比较差异均无统计学意义(P>0.05)。单胎组孕期流产5例(术后4周内流产1例),活产胎儿94个;双胎组孕期流产9例(术后4周内流产2例)、孕期自然减为单胎12例,活产胎儿112个。2组均无缺陷儿出生。单胎组分娩孕周、新生儿体质量[(38.74±1.84)周、(3.24±0.60)kg]均大于双胎组[(36.93±2.30)周、(2.52±0.49)kg](t=5.443,P<0.001;t=9.482,P<0.001),早产率、NICU治疗率(5.32%、4.26%)均低于双胎组(37.10%、12.50%)(χ^(2)=25.616,P<0.001;P=0.037),足月产率(92.55%)高于双胎组(59.68%)(χ^(2)=24.764,P<0.001);2组总流产率、术后4周内流产率、活产率、极早产率、妊娠期并发症发生率比较差异均无统计学意义(P>0.05)。结论 含单绒毛膜双胎的三胎妊娠孕妇行减胎术保留单胎者妊娠结局优于保留双胎者,保留双胎者另1胎易自然减灭。
Objective To compare the pregnancy outcomes of multifetal pregnancy reduction in triplet pregnancies with monochorionic twins, and to investigate the efficacy of multifetal pregnancy reduction. Methods In 170 monochorionic triplet pregnant women undergoing transvaginal ultrasound-guided embryo reduction in gestational week 7 to 9, 151 patients underwent fetal reduction from twins to singleton and the ultrasound examination 3 days after surgery showed twin survival in 71 women and singleton survived in 80 women, and the remained 19 women underwent fetal reduction of triplets to singleton and the ultrasound examination 3 days after surgery showed that all singletons survived. The clinical data as age, body mass index, gravidity and frequency of preoperative miscarriage were compared between 71 twins survival(twins group) and 99 singleton survival(singleton group). The miscarriage rate, live birth rate, gestational week at delivery, pregnant complications, term birth rate, premature birth rate, extreme premature birth rate, birth weight and neonatal intensive care unit(NICU) treatment rate were also compared between two groups. Results There were no significant differences in the age, body mass index, gravidity, frequency of preoperative miscarriage and gestational age at reduction between two groups(P>0.05). There were 5 cases of miscarriage during pregnancy(1 miscarriage within 4 weeks after surgery) and 94 live births in singleton group, and 9 cases of miscarriage(1 miscarriage within 4 weeks after surgery), 12 cases of spontaneous reduction to singleton and 112 live births in twins group. No defective babies were born in either group. The gestational week at delivery and the average birth weight were significantly higher in singleton group [(38.74±1.84)weeks,(3.24±0.60) kg] than those in twins group [(36.93±2.30) weeks,(2.52±0.49) kg](t=5.443, P<0.001;t=9.482, P<0.001), the premature birth rate and NICU treatment rate were significantly lower in singleton group(5.32%, 4.26%) than those in twins group(37.10%,
作者
孔秀丽
史昊
卜志勤
王芳
KONG Xiu-li;SHI Hao;BU Zhi-qin;WANG Fang(Reproductive Medical Center,the First Af filiated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)
出处
《中华实用诊断与治疗杂志》
2022年第11期1142-1144,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
国家自然科学基金青年项目项目(81801448)。
关键词
单绒毛膜双胎
三胎妊娠
多胎妊娠减胎术
妊娠结局
dichorionic twins
dichorionic triplets
multifetal pregnancy reduction
pregnancy outcomes
