多胎妊娠减胎术16例临床分析  

Clinical analysis of multifetal pregnancy reduction in 16 cases

作　　者：陈小琴[1] 李予[1] 王文军[1] 李晓虹[1] 陈向红[1] 陈玉珍[1] 陈晓丽[1] 杨冬梓[1] 张清学[1] 

机构地区：[1]广州中山大学附属第二医院妇产科生殖中心,510120

出　　处：《中国妇产科临床杂志》2007年第6期415-417,共3页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的研究多胎妊娠早期选择性减胎术的可行性、安全性及对妊娠的影响。方法2002年1月-2005年12月在我院生殖中心行体外受精-胚胎移植受孕的16例多胎妊娠（A组）孕早期在阴道B超引导下穿刺,采用氯化钾心腔内注射或单纯胚芽穿刺抽吸法行减胎术,并与同期进行体外受精-胚胎移植受孕的64例双胎妊娠（B组）相比较。结果16例减胎术均一次成功。其中3例流产,13例患者已分娩（其中早产5例）,24个新生儿平均孕周（37.2±1.4）周,出生体重（2660.0±417.5）g,均健康无畸形。B组64例患者中4例孕早期流产,3例孕晚期流产,57例（其中早产24例）分娩109个新生儿,其中2个重度窒息死亡,2个先天畸形,平均孕周（37.0±2.0）周,出生体重（2603.3±459.7）g。两组的流产率、活产率、早产率、平均孕周、平均出生体重等均无明显差别。结论在B超引导下,多胎妊娠早期减胎术是安全、有效治疗多胎妊娠的方法。Objective To explore the feasibility and safety of early multifetal pregnancy reduction and its impact on the outcome of pregnancy. Methods From January 2002 to December 2005, 16 muhifetal women （group A） resulted form IVF - in reproduction center in our hospital underwent muhifetal pregnancy reduction by potassium chloride （KC1） intra chambers heart administration or cardiac and aspiration merely under the guidance of transvaginal ultrasound. The pregnancy outcome was compared between these women and the control group （group B ） that included a total of 64 cases of twin pregnancies resulted from IVF - ET during the same period. Results The multifetal pregnancy reduction was performed successfully in one time in all 16 cases. Three abortions were observed. 13 women had delivered （5 women had preterm deliveries）. The mean gestational age at delivery of the 24 newborns was （37.2±1.2） weeks, and the mean birth weight was （2 660.0±417.5） g. The neonates ware all healthy and no abnormality was found. 4 early abortions and 3 lately abortions were found in 64 cases of group B. 109 newbo- rns born from 57 deliveries （including 24 preterm cases）, among them, 2 newborns dead for severe asphyxia, 2 cases had abnormality. The mean gestational age at delivery was （37.0±2.0） weeks and the mean birth weight was （2 603.3±459.7） g. No significant difference was found between the two groups in rates of miscarriage, live birth, preterm delivery and low birth weight. Conclusion Multifetal pregnancy reduction under the guidance of ultrasound is a relatively safe and efficient method for treatment the multifetal pregnancy.

关 键 词：减胎术 多胎妊娠 超声检查 临床分析 

分 类 号：R714.23[医药卫生—妇产科学]