双胎妊娠经阴道分娩的经验交流  

Influence on the Childbirth Way and Pregnancy Outcome in Twin Pregnancy

作　　者：冯秀山[1] 张延珍[1] 陈玲[1] 

机构地区：[1]福建医科大学附属协和医院妇产科,福建350001

出　　处：《妇产与遗传（电子版）》2013年第4期40-44,共5页Obstetrics-Gynecology and Genetics (Electronic Edition)

摘　　要：目的探讨孕周≥34周双胎妊娠产妇的分娩方式对母亲和新生儿结局的影响。方法收集福建医科大学附属协和医院2006年6月至2013年5月60例孕周≥34周双胎妊娠产妇的临床资料,根据分娩方式的不同分为阴道分娩组(11例)和剖宫产组(49例),对其资料进行回顾性分析。结果阴道分娩组胎方位以头-头位为主,余为头-臀位,而剖宫产组胎方位多样。阴道分娩组无妊娠合并症,而剖宫产组妊娠合并症为37例(75.51%)。两组产妇的分娩孕周、产后出血发生率、输血发生率均无显著性差异(χ2=1.97,P=0.16;χ2=0.63,P=0.43;χ2=1.88,P=0.17)。活产新生儿120例。两组新生儿体重、窒息发生率、入住NICU(新生儿重症监护室)率无显著性差异(χ2=1.53,P=0.22;χ2=2.78,P=0.10;χ2=0.24,P=0.62)。但剖宫产组住院时间显著增加(t=5.46,P<0.05)。结论双胎妊娠产妇无合并症或者合并症轻微,胎方位为头/头、头/臀位,胎儿体重相对较小,可考虑经阴道分娩。Objective To study the relationship between childbirth way and pregnancy outcome in twin pregnancy after 34 weeks. Methods Clinical data of 60 cases of twin pregnancy women, which were divided into two groups according to the delivery mode from Jan. 2006 to May. 2013 were analyzed retrospectively. Results The head-head position is the main fetal position in vaginal delivery group, and the other is head-breech. Cesarean group fetal position is diverse. Vaginal delivery group had no pregnancy complications, and there is 37cases (75.51%) in cesarean group. There was no difference in gestational weeks, postpartum hemorrhage, transfusion rate (χ2=1.97,P=0.16;χ2=0.63,P=0.43;χ2=1.88, P=0.17). There are 120 cases of live birth. There was no difference in neonatal weight, neonatal asphyxia and neonatal NICU (Neonatal Intensive Care Unit) occupancy rate of two groups (χ2=1.53,P=0.22;χ2=2.78,P=0.10;χ2=0.24,P=0.62). Cesarean section is in the hospital for a long time. Conclusion Twin pregnancy women without complications or minor, the fetal position is the head/head, head/breech and low birth-weight, which is beneficial to vaginal delivery.

关 键 词：妊娠 多胎 自然分娩 剖宫产术 

分 类 号：R714.4[医药卫生—妇产科学]