多胎减胎术及其对母胎婴预后的影响  

The Multifetal Reduction Technology and Its Influence on Mother and Fetus

作　　者：谭雯雅[1] 陈雷宁[1] 全松[1] 

机构地区：[1]南方医科大学南方医院妇产科生殖医学中心,广州510515

出　　处：《国际生殖健康／计划生育杂志》2012年第6期462-466,共5页Journal of International Reproductive Health/Family Planning

摘　　要：随着辅助生殖技术的发展,医源性多胎妊娠的发生率显著增高。多胎妊娠明显增加了早产、流产、低体质量儿、双胎输血综合征和胎膜早破等风险,严重影响母胎结局。减胎术作为控制多胎妊娠的重要补救措施已被广泛应用,有效降低了多胎妊娠并发症及母婴风险。近年来减胎术实施时机、途径、方法及其对母婴预后影响的研究表明,一般在妊娠早期(7～8周)实施经阴道减胎术,选择性减胎术则在12～14周实施为宜。经阴道抽吸胚胎的安全性及有效性最佳。尽管多胎减胎术有利于降低多胎妊娠的母婴风险,但减胎术操作本身具有一定损伤性。因此,需要进一步改良实验室培养胚胎、冷冻及解冻、选择胚胎技术及选择最佳移植时机,进而从源头上减少多胎妊娠的发生。目前已出现提倡选择性单胚胎移植趋势。The incidence of iatrogenic muhifetal pregnancy was significantly inereased as the development of assisted reproductive technology. Mulfifetal pregnancy increased the risk of premature delivery, misearriage,low birth weight,twin transfusion syndrome and premature rupture of membranes. Those adverse events seriously affected the maternal-fetal outcome. Fetal reduction as an important remedial measures to control multiple pregnancy has been widely used to reduce complications and risks of maternal and child. This article reviewed the timing,means,methods,and impact on maternal and child of the muhifetal reduction in recent years. Generally,the muhifetal reduction operation was done via vagin in early gestation （7~8 weeks）, while the selective multifetal reduction operation in 12~14 weeks. Transvaginal aspiration of embryo may be the most effective and safe. However,the operation itself may cause uncertain damage. Therefore,it is neeessary to improve techniques of embryos culture, cryopreservation and thawing as well as embryo selection,and to choose the best transplantation timing,to reduce the oeeurrenee of multiple pregnancy. At present,the selective single embryo transplantation was advocated.

关 键 词：妊娠 多胎 妊娠减少 多胎 妊娠结局 生殖技术 辅助 

分 类 号：R719[医药卫生—妇产科学]