单绒毛膜双羊膜囊双胎的孕期管理及分娩方式探讨  

A preliminary study on the management of pregnancy and delivery of monochorionic diamniotic twin

作　　者：李彦军[1] 郝静[1] 曹志宏[1] 唐莉鸿 孙羽[1] 

机构地区：[1]首都医科大学燕京医学院附属良乡医院妇产科,北京102400

出　　处：《临床和实验医学杂志》2017年第11期1138-1140,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨单绒毛膜双羊膜囊双胎的孕期管理及分娩方式。方法收集2013年1月至2016年6月在首都医科大学燕京医学院附属良乡医院定期行产前检查并分娩、资料完善的双胎妊娠孕妇205例,分为单绒毛膜双羊膜囊组(单绒毛膜组)、双绒毛膜双羊膜囊组(双绒毛膜组),比较两组妊娠期并发症、早产、分娩方式和围产结局。单绒毛膜组又分为普通孕检组、加强孕检组,比较不同孕检方式的围产儿情况。结果单绒毛膜组与双绒毛膜组妊娠期高血压疾病、妊娠期糖尿病的发生率比较,差异无统计学意义(P>0.05),单绒毛膜组剖宫产率、早产率、低出生体重儿、死胎率、围产儿病死率明显高于双绒毛膜组,差异有统计学意义(P<0.05)。单绒毛膜组有4例在孕期发生双胎输血综合征,发生率12.5%;有6例发生选择性胎儿生长受限,发生率18.6%。结论对于单绒毛膜双羊膜囊双胎妊娠,应加强孕期管理,改善围产儿预后。Objective To explore the management of pregnancy and delivery of monochorionic diamniotic twin. Methods The clinical data of 205 cases of pregnant women during January 2013 to June 2016 in this hospital got regular prenatal care and delivery were retrospectively collected and analyzed in order to improve the management of pregnancy. They were divided into monochorionic diamnionic group （monochorionic group） and double chorionic diamnionic group （ dichorionic group）. The incidence of complications of pregnancy, premature delivery, mode of de-livery and perinatal outcome were compared between these 2 guops. Patients in monochorionic group were further divided into normal pregnancy examination group and reinforced pregnancy examination group. Results The incidence rates of gestational hypertension, gestational diabetes were compared between monochorionic group and dichorionic group, and the difference was not statistically significant （ P〉0.05） . The incidence rates of cesarean section, premature delivery, low birth weight, fetal death rate and perinatal mortality in monochorionic group were significantly higher than those of dichorionic group, and the difference was statistically significant （P 〈0.05） . There were 4 cases with twin transfusion syndrome during pregnancy in monochorionic group, and the incidence rate reached as high as 12.5% , and there was selective fetal growth restriction in 6 patients, with a rate of 18.6% . Conclusion For pregnant women with monochorionic or diamnionic twin pregnancy, the pregnancy management should be strengthened in order to improve the perinatal prognosis.

关 键 词：单绒毛膜双羊膜囊双胎 孕期管理 分娩方式 

分 类 号：R714[医药卫生—妇产科学]