体外受精-胚胎移植助孕后双胎自然减胎的妊娠结局  

Risk factors and consequence of spontaneous pregnancy reduction in twin pregnancy after in vitro fertilization and embryo transfer

作　　者：张焕焕[1] 项兰[1] 魏兆莲[1] 吴娟[1] 徐玉萍[1] 章志国[1] 纪冬梅[1] 

机构地区：[1]安徽医科大学第一附属医院生殖中心,合肥230022

出　　处：《生殖医学杂志》2014年第7期535-538,共4页Journal of Reproductive Medicine

基　　金：国家自然科学基金(2012BA132B01)

摘　　要：目的探讨体外受精-胚胎移植(IVF-ET)助孕妊娠后双胎自然减为单胎的影响因素以及妊娠结局。方法回顾性分析2010年3月至2012年7月在本院生殖中心行试管婴儿助孕的8 567个周期,双胎妊娠自然减为单胎者为研究组(A组,166例),对照为双胎未发生减胎组(B组,264例)和单胎组(C组,200例)。比较3组间临床相关因素及妊娠结局。结果 A组的妊娠年龄、新鲜周期HCG日内膜厚度/复苏周期排卵日内膜厚度高于B组,差异有统计学意义(P<0.05);A组移植胚胎质量低于B组,差异具有统计学意义(P<0.05);A组早期妊娠流产率低于B组(3.61%vs.12.50%),差异有统计学意义(P<0.05);但A组晚期妊娠流产率高于B组(10.24%vs.4.00%),差异有统计学意义(P<0.05)。A组妊娠期高血压的发生率高于C组(11.45%vs.5.50%),差异有统计学意义(P<0.05)。A组妊娠期糖尿病的发生率高于C组(4.82%vs.2.50%),但差异无统计学意义(P>0.05)。A组与C组比较,低体重儿、早产儿出生率及新生儿体重、出生孕周差异均无统计学意义(P>0.05)。结论妊娠年龄大于35岁、内膜厚度小于10mm,移植优质胚胎数目比率越低,双胎妊娠发生自然减胎的可能性越大。双胎自然减为单胎的孕妇较正常单胎妊娠者发生妊娠并发症的风险增加。Objective： To investigate the risk factors and consequence of spontaneous pregnancy reduction in twin pregnancy following in vitro fertilization and embryo transfer（IVF-ET）. Methods： A retrospective cohort study including 8 567 IVF-ET cycles was conducted in the Infertility Center of Anhui Medical University from March 2010 to July 2012. The risk factors and consequence were compared among the patients experienced spontaneous reduction in twin pregnancy （group A, 166 patients） , the patients with twin pregnancy but no occurrence of spontaneous reduction（group B, 264 patients） ,and the patients with singleton pregnancy（group C,200 patients）. Results： There were significant differences in maternal age, embryo quality and endometrial thickness（P〈 0.05）except number of embryo transferred between group A and B（P〉0.05）. The incidence of hypertension in group A was significantly higher than that in group C（11. 45 % vs. 5.50% ,P〈0. 05）. Early abortion rate（3.61% vs. 12.50%）was significantly lower and the late abortion rate（10.24% vs. 4. 00%）was significantly higher in group A than that in group C（P〈0.05）. The rates of low birth weight infants, premature baby,birth weight and gestational age had no significant difference between group A and group C（P〉0. 05）. Conclusions. A maternal age more than 35,endomitrium less than high-quality embryos are associated with spontaneous pregnancy reduct of spontaneous pregnancy reduction is associated with increased risk of 10 mm and ion in twin decrease in pregnancy number of Occurrence pregnancy complications.

关 键 词：自然减胎 双胎妊娠 妊娠结局 体外受精-胚胎移植 

分 类 号：R714[医药卫生—妇产科学]