含单绒毛膜的三胎妊娠选择性减胎策略评价  

Selective fetal reduction for monochorionic and dichorionic triplet

作　　者：李优 魏瑗[1] 赵扬玉[1] Li You;Wei Yuan;Zhao Yangyu(Department of Obstetrics and Gynecology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院妇产科,100191

出　　处：《中华围产医学杂志》2021年第10期778-782,共5页Chinese Journal of Perinatal Medicine

基　　金：国家重点研发计划(2018YFC1002904)。

摘　　要：与三绒毛膜三胎相比,单绒毛膜三胎和双绒毛膜三胎由于包含了单绒毛膜多胎,并发症风险高,常导致不良妊娠结局。相对于期待治疗,几种常用的减胎策略均可以降低早产率、延长孕周、增加胎儿体重。减去独立胎盘胎儿无法避免单绒毛膜双胎并发症;减去单绒毛膜双胎之一可能会出现留存胎儿死亡且对术者的技术要求高;减去单绒毛膜双胎结局最好。对单绒毛膜三胎减胎策略的评价仍需要更多研究数据。现就不同的减胎数目、减胎对象和手术方式对单绒毛膜三胎和双绒毛膜三胎妊娠结局的影响进行综述。Monochorionic triplet and dichorionic triplet pregnancies result in a higher risk of complications than trichorionic triplet due to its monochorionic part,and often lead to adverse pregnancy outcomes.We discuss the impact of different fetal reduction numbers,object and surgical methods on the outcome of monochorionic triplet and dichorionic triplet pregnancies.Compared with expectant management,several common fetal reduction strategies can reduce the risk of premature birth,prolong gestational weeks,and increase fetal birth weight.Reduction of the fetus with a separate placenta does not avoid the complications of monochorionic twins,and reducing one of the monochorionic pairs might cause the death of the remaining fetus,thereby requiring skilled surgeons.So,reduction of the monochorionic pair was preferred.More study are needed to evaluate the reduction strategy of monochorionic triplet.

关 键 词：三胎 妊娠 三胎 妊娠减少 多胎 妊娠结局 

分 类 号：R714.23[医药卫生—妇产科学]