体外受精-胚胎移植中含单绒毛膜双胎的三胎减胎术后妊娠结局分析  

Outcomes of multifetal pregnancy reduction strategies in triplet pregnancies with monochorionic twins in IVF-ET cycles

作　　者：耿嘉瑄[1] 张宜瑄[1] 帖晓丹 徐晓航[1] 张翠莲[1] 

机构地区：[1]河南省人民医院生殖中心,郑州450000

出　　处：《生殖与避孕》2015年第8期571-574,共4页Reproduction and Contraception

摘　　要：目的:探讨体外受精-胚胎移植(IVF-ET)中移植2枚胚胎后发生三胎妊娠行单绒毛膜双胎中一胎减灭术后的妊娠结局。方法:回顾性分析27例行单绒毛膜双胎中一胎减灭术的三胎妊娠患者的临床资料,了解术后一般情况,并对比术后仍保留双胎妊娠的与同期非减胎双胎妊娠的妊娠结局及新生儿情况。结果:减胎术后有12例(44.44%)发生自然减灭仅留一胎;保留双胎组与非减胎双胎组患者平均年龄、平均孕周及平均胎儿出生体质量无统计学差异(P>0.05);早期均无流产发生,晚期流产率分别为6.67%和10.00%,抱婴回家率分别为93.33%、90.00%,早产率分别为21.43%和37.04%,低体质量儿出生比例分别为21.43%和33.33%,围产儿死亡率分别为0.0%和3.7%,组间均无统计学差异(P>0.05),减胎后双胎组和非减胎双胎组均无畸形儿出生。结论:行减灭单绒毛膜双胎中一胎的减胎术有近一半的患者另一胎会发生自然减灭,余保留双胎的妊娠结局和新生儿一般情况与非减胎双胎妊娠组无统计学差异。Objective： To investigate the outcomes of the triplet pregnancy after transplanting two em- bryos during in vitro fertilization-embryo transfer （IVF-ET） which underwent a row monozygotic twin fetal cytoreductive surgery. Methods： A retrospective analysis was performed in a row monozygotic twin fetal cytoreductive surgery in triplet pregnancy with a total of 27 cases. The remaining twin pregnancy patients after surgery were considered as group A, and 30 cases of non-reduced fetal twin pregnancy were collected as group B. The pregnant outcomes and newborn infants indexes were compared between the two groups. Results： Totally, fetal reduction in 12 cases （44.44%） occured naturally after cytoreductive leaving only one child. The patients＇ average age, the mean gestational age and the mean birth weight had no significant differences between group A and group B; no early abortion happened in the two groups. Late abortion rate was 6.67% in group A and 10.00% in group B, respectively, with no significant difference. Hold infant home rate （93.33% vs 90.00%）, preterm birth rate （21.43% vs 37.04%）, the proportion of low birth weight （21.43% vs 33.33%）, and perinatal child mortality rate （0.0% vs 3.7%） were not significantly different between the two groups. There were no newborn deformed in the two groups. Conclusion： Less than half of the triplet pregnants underwent the monozygotic twin fetal cytoreductive surgery occurs naturally after cytoreductive leaving only 9ne child, and the other are still available to retain the twins. The two groups had similar pregnancy outcomes and neonatal conditions.

关 键 词：多胎减胎术 含单绒毛膜双胎的三胎妊娠 妊娠结局 

分 类 号：R714.23[医药卫生—妇产科学] R714.8[医药卫生—临床医学]