双胎妊娠绒毛膜性判定与妊娠结局868例临床分析  

Clinical analysis of chorionicity identification and pregnancy outcome of 868 twin pregnancies

作　　者：张杉杉[1] 张志涛[1] 庄艳艳[1] 刘思诗[1] 刘彩霞[1] 

机构地区：[1]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11期1034-1037,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：辽宁省产科疾病转化医学研究中心及协同研究网络建设-双胎妊娠的早期筛查监测和治疗的基础临床转化研究(2014225007)

摘　　要：目的探讨已知绒毛膜性与未知绒毛膜性、单绒毛膜性与双绒毛膜性双胎妊娠孕产妇和围产儿临床结局。方法收集2013年辽宁省五家医院终止妊娠的双胎孕产妇资料,分别比较已知绒毛膜性组与未知绒毛膜性组、单绒毛膜性组与双绒毛膜性组孕产妇及围产儿妊娠结局的差异。结果未知绒毛膜性组剖宫产、产后出血、极低出生体重儿、低出生体重儿、围产儿死亡发生率明显高于已知绒毛膜性组(P<0.05),单绒毛膜性组低出生体重儿、围产儿死亡、新生儿重度窒息发生率明显高于双绒毛膜性组(P<0.05),不同绒毛膜性双胎妊娠妊娠期高血压疾病、妊娠期糖尿病、胎膜早破等妊娠期并发症的发生率比较,差异无统计学意义(P>0.05)。结论不同绒毛膜性双胎妊娠孕产妇并发症间无明显差异,未知绒毛膜性组、单绒毛膜性组围产儿不良预后明显增多。双胎妊娠应在孕早期行绒毛膜性判定,加强单绒毛膜性双胎妊娠的孕期及围产期管理,对改善围产儿预后具有重要意义。Objective To discuss the maternal and perinatal outcome of known and unknown chorionic twin pregnancy, monochorionic and dichorionic twin pregnancy. Methods We collected the clinical data of twin pregnancy of five hospitals in Liaoning province in 2013, excluding the ones who were not terminated pregnancy when discharged from hospital, to analyze the difference of maternal and perinatal outcomes between known and unknown chorionic twin pregnancy, monochorionic and dichorionic twin pregnancy respectively. Results The incidence of cesarean section, postpartum hem- orrhage, very low birth weight infants, low birth weight infants, perinatal death in unknown chorionic twin pregnancy was significantly higher than in known ehorionic twin pregnancy（P 〈 0.05）. In monochorionic twins, the incidence of low birth weight infants, perinata] death and severe neonatal asphyxia was significantly higher than in dichorionic ones（P 〈 0.05）. There was no significant statistically difference in maternal complications（P 〉 0.05）. Conclusion No significant differ- ence could be seen in maternal complications of twin pregnancy with different chorionicities. Unknown chorionie and monochorionic twins had worse perinatal outcome. We should identify the choriouicity of twins early in pregnancy, strengthen the pregnancy and perinatal management of monoehorionic twins to improve the perinatal prognosis.

关 键 词：双胎妊娠 绒毛膜性判定 产后出血 剖宫产 围产儿预后 

分 类 号：R714.461[医药卫生—妇产科学]