多胎妊娠中孕期选择性减胎术  

Se1ective multifetal pregnancy reduction in second trimester

作　　者：李红燕[1] 李善玲[1] 王谢桐[1,2] 刘彩霞[3] 

机构地区：[1]山东大学附属省立医院妇产科,山东济南250021 [2]山东省妇幼保健院妇产科,山东济南250014 [3]中国医科大学附属盛京医院妇产科,辽宁沈阳110004

出　　处：《中国实用妇科与产科杂志》2015年第7期602-607,共6页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家卫生计生委公益性卫生行业科研项目(201402006)

摘　　要：中孕期妊娠选择性减胎术主要目的是减少多胎妊娠胎儿数、减灭异常胎儿，改善多胎妊娠结局。在排除单绒毛膜双胎的情况下，药物减胎比较成熟和安全，一般在妊娠11～24周实施，妊娠成功率接近自然双胎。对于单绒毛膜双胎采用血管闭塞的技术进行选择性减胎，国内多采用射频消融，一般选择在15～27周。手术适应证、手术时机、手术方法以及术者的熟练程度与妊娠结局有关。减胎术前应行超声检查判断绒毛膜性、诊断早期胎儿异常和识别双胎特殊并发症。Selective multifetal pregnancy reduction in second trimester aims to improve pregnancy outcomes by reducing the numbers of fetus or abnormal fetus. Intracardiac injection of KC1 usually managed from 11 to 24 weeks is proven relatively safe, but this method is not suitable for monochorioic twin pregnancies. Its successful pregnancy rate is close to spontaneous pregnancy twins. Multifetal reduction of monochorioic twin pregnancies is managed with vascular occlusion technique from 15 to 27 weeks, and radiofrequency ablation is more widely used in China.Pregnancy outcomes are related to surgical indications, surgical times, surgical procedures and performers＂ experience. Assessment of chorionicity, early diagnosis of fetal abnormalities and identification of twin pregnancy complications should be done by ultrasonography before pregnancy reduction.

关 键 词：多胎妊娠 妊娠中期 选择性减胎 妊娠 结局 

分 类 号：R714.23[医药卫生—妇产科学]