12例双胎妊娠中孕期选择性减胎治疗临床分析  

Clinical Analysis of 12 Cases of Twin Pregnancy and Selective Fetal Reduction During Second Trimester

作　　者：徐玉萍[1,3,4] 姜小花 袁静 方慧琴[2] 杨梦楠[5] 邢琼 魏兆莲[1,3,4] 曹云霞 XU Yu-ping;JIANG Xiao-hua;YUAN Jing;FANG Hui-qin;YANG Meng-nan;XING Qiong;WEI Zhao-lian;CAO Yun-xia(Reproductive Medicine Center,Department of Obstetrics and Gynecology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Prenatal Diagnosis Center of Obstetrics and Gynecology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Anhui Province Key Laboratory of Reproductive Health and Genetics,Hefei 230022,China;Biopreservation and Artificial Organs, Anhui Provincial Engineering Research Center,Hefei 230022,China;Department of First Clinical Medical Institute,Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院妇产科生殖医学中心,合肥230022 [2]安徽医科大学第一附属医院妇产科产前诊断中心,合肥230022 [3]安徽医科大学生殖健康与遗传安徽省重点实验室 [4]安徽省生命资源保存与人工器官工程技术研究中心 [5]安徽医科大学第一临床医学院

出　　处：《国际生殖健康／计划生育杂志》2019年第4期279-282,共4页Journal of International Reproductive Health/Family Planning

基　　金：安徽省教育厅高校科学研究项目(KJ2018A0190)

摘　　要：探讨双胎妊娠中孕期选择性减胎治疗的安全性、有效性及其影响因素。12例双胎妊娠患者因在中孕期发现其中一个胎儿存在结构或染色体异常而行选择性减胎治疗。回顾性分析12例患者选择性减胎手术情况、术后妊娠期并发症、产科结局及新生儿情况。12例患者均在中孕期成功减胎。其中4例足月分娩,3例早产,1例晚期流产、胎儿存活,1例流产,3例持续妊娠中;8例已分娩患者(剖宫产3例,阴道分娩5例)平均分娩孕周为34+1周,新生儿平均出生体质量(2 290.00±963.52)g,新生儿平均出生身长(44.88±6.01)cm,8例出生新生儿均未见缺陷。中孕期选择性减胎术对异常胎儿与正常胎儿并存的双胎妊娠是一种安全的治疗手段,可以有效地降低母胎并发症、防止先天性缺陷儿出生。To investigate the safety, effectiveness and the influence factors of selective reduction during the second trimester in patients with twin pregnancy. We retrospectively analyzed the data of 12 patients with twin pregnancy who conducted the selective reduction during their second trimester. Each case was due to the structure or chromosomal abnormalities in one of two fetuses. Conditions during the surgery, gestational complications,obstetric outcomes and neonatal conditions after the surgery were assessed. All the patients were successfully conducted the selective reduction. Among the 12 patients, 4 cases had term birth baby, 3 cases had preterm birth baby, 1 case had late abortion but fetal survival, 1 case had a miscarriage and 3 cases had unbroken gestation.The average gestational weeks in those who had delivered babies(3 cases were caesarean section and 5 cases were natural delivery) were 34+1. The mean weight and height of the neonates were(2 290.00±963.52) g and(44.88±6.01) cm. No defects were found in the newborn babies. In conclusion, the selective reduction during the second trimester is safe for those patients with coexisted abnormal and normal fetus. This operation will reduce the maternal and fetal complications, as well as prevent effectively the birth of babies with congenital defect.

关 键 词：妊娠 双胎 妊娠减少 多胎 妊娠中期 先天畸形 

分 类 号：R714.23[医药卫生—妇产科学]