双胎妊娠1胎胎死宫内13例临床病例分析  

Twin Pregnancy with Single Fetal Death:Clinical Analysis of 13 Cases

作　　者：赫英东[1] 李雨利[1] 陈倩[1] 

机构地区：[1]北京大学第一医院妇产科,100034

出　　处：《中国产前诊断杂志（电子版）》2010年第1期30-33,共4页Chinese Journal of Prenatal Diagnosis(Electronic Version)

基　　金："十一.五"国家科技支撑计划项目资助;课题名称:<严重胎儿结构异常影像学筛查和诊断新技术的研究>项目编号:2006BAI05A04

摘　　要：目的探讨双胎妊娠1胎胎死宫内存活胎儿临床预后及处理方法。方法回顾性分析2000年1月至2009年6月于本院分娩的13例孕中晚期双胎妊娠1胎胎死宫内病例。结果双胎妊娠1胎胎死宫内的发生率为2.83%,13例双胎妊娠1胎胎死宫内的患者,7例为单绒毛膜双胎,6例为双绒毛膜双胎。共8名患者接受了期待治疗。1胎胎死宫内确诊的平均孕周为31+4周。双胎妊娠1胎胎死宫内较早期早产(<34周)的发生率单绒毛膜双胎者高于双绒毛膜双胎者,分别为57.1%(4/7),33.3%(2/6);新生儿死亡率分别为33.3%(2/6),0(0/5)。期待治疗的患者中,1例出现了弥漫性血管内凝血,并因此终止妊娠。5名接受经颅多普勒超声检查的新生儿,3名存在颅内病变。结论孕中晚期双胎妊娠1胎胎死宫内者,单绒毛膜双胎妊娠者预后较差。对胎死宫内发生时间较早者,可在密切监测下行期待治疗以降低早产的发生率,改善预后。Objective To investigate the prognosis and management of twin pregnancy complicated with single fetal demises. Methods Retospective analysis of the 13 cases of twin pregnancy complicated with single fetal demises that were deliveried in our hospital between January 2000 and June 2009.Results The incidence of twin pregnancy complicated with single fetal demises is 2.83%,7 of the 13 cases were dichorionic and the other 6 cases were monochrionic.8 cases received expectant management.The mean gestional age at the time of fetal death diagnosis was 31+4 weeks.The incidence of early premature delivery was higher in the monochrinic cases than that in the dichorionic cases,respectively 57.1%(4/7) vs 33.3%(2/6);the mortality of the newborns was respectively 3.3%(2/6) and 0(0/5).In the patients who received expectant management,1 case appeard disseminated intravascular coagulation.5 infants received Transcranial Doppler Ultrasonography examination,3 of them were found to have intracranial lesions.Conclusion The prognosis of twin pregnancy complicated with single fetal demises which were diagnosied in the second and third tremister was worse in the monochrionic cases.Expectant management is appropriate for twin pregnancy complicated with single fetal demises that were diagnosied in the second tremister in order to improve the prognosis of the infants.

关 键 词：双胎妊娠 1胎胎死宫内 期待治疗 

分 类 号：R714.2[医药卫生—妇产科学]