单羊膜囊双胎妊娠围产期管理与妊娠结局  

Perinatal management of monochorionic monoamnionic twin pregnancy and outcomes

作　　者：郭琳琼 薛翔[1] GUO Linqiong;XUE Xiang(Department of Gynecology and Obstetrics,Second Affiliated Hospital ofXi an Jiaotong University,Xi an 710004,China)

机构地区：[1]西安交通大学第二附属医院妇产科,陕西西安710004

出　　处：《国外医学（医学地理分册）》2018年第1期40-43,共4页Foreign Medical Sciences：Section of Medgeography

摘　　要：目的探讨单绒毛膜单羊膜囊(monochorionic monoamniotic,MCMA)双胎妊娠的围产期监护、处理及妊娠结局。方法收集2014年2月至2016年8月,在西北妇女儿童医院产科分娩的MCMA双胎,按照分娩孕周≥28周的标准选取13例孕妇的临床资料,回顾性分析孕妇的基本情况、合并症、围产期监护及妊娠结局。结果(1)13例MCMA双胎孕妇的平均年龄(29.3±4.7)岁,其中初产妇11例,经产妇2例;自然受孕12例,体外受精胚胎移植术后1例。(2)MCMA双胎13例中不规律产检组6例,平均分娩孕周为(34.3±3.2)周。其中5例急诊剖宫产,1例择期剖宫产;规律产检组7例,平均分娩孕周为(33.0±0.4)周;2例急诊剖宫产,5例择期剖宫产。术后证实脐带因素占76.9%(10/13)。(3)胎死宫内1例;活产新生儿25例,有22例出生后转NICU治疗,其中1例因"胎膜早破、羊水过少"急诊剖宫的双胎之一因多脏器功能衰竭死亡;围产儿死亡均发生在不规律产检组。结论单羊膜囊双胎妊娠围产儿死亡率高,早产风险大,规律的产前检查及加强围产期管理有助于改善妊娠结局。The average age of women was(29.3±4.7)years.Of the 13 cases,11 cases were primiparas,2 cases were multiparas;12 cases were spontaneous pregnancy and 1 was after in vitro fertilization(IVF).②Of the 13 cases,7 cases received regular inspection while the other 6 cases irregular inspection.For the irregular group,the average gestational age was(34.3±3.2)weeks;5 cases had emergency cesarean section,and 1 case had elective cesarean section.For the regular inspection group,the average gestational age was(33.0±0.4)weeks;2 cases had emergency cesarean section,and 5 cases had elective cesarean section.③There was 1 stillbirth and 25 cases live births,22 cases of whom were transferred to the neonatal intensive care unit(NICU),and 1 case newborn died of multiple organ failure.Both perinatal deaths occurred in the irregular inspection group.Conclusion The perinatal mortality and premature delivery risk of MCMA twin pregnancy are high.Regular prenatal care and perinatal management can improve pregnancy outcomes.

关 键 词：单绒毛膜单羊膜囊 双胎 围产期管理 妊娠结局 

分 类 号：R734[医药卫生—肿瘤]