辅助生殖术中高龄多胎妊娠患者行早孕期减胎术的妊娠结局分析  

Analysis of pregnancy outcomes in elderly patients with multiple pregnancies undergoing early pregnancy reduction during assisted reproduction

作　　者：覃华梅 莫似恩 王书佳 黄晖 姚小成 王安然 罗薇薇 Qin Huamei;Mo Sien;Wang Shujia;Huang Hui;Yao Xiaocheng;Wang Anran;Luo Weiwei(Department of Reproduction,Guangxi Zhuang Autonomous Region Reproductive Hospital,Nanning 530029,China)

机构地区：[1]广西壮族自治区生殖医院生殖科,广西南宁530029

出　　处：《实用妇科内分泌电子杂志》2024年第4期48-51,共4页Electronic Journal of Practical Gynecological Endocrinology

摘　　要：目的探讨高龄不孕患者在辅助生殖助孕后多胎妊娠行减胎术的妊娠结局,分析其必要性及安全性。方法回顾性分析191例≥35岁不孕患者行辅助生殖技术(ART)获得多胎妊娠行减胎术的临床资料,其中110例为减胎后保留单胎为减为单胎组(包括四胎减为单胎2例、三胎减为单胎21例、双胎减为单胎87例),81例为减胎后保留双胎为减为双胎组(包括四胎减为双胎1例、三胎减为双胎80例);另随机选取同期≥35岁行ART单胎妊娠454例为未减单胎组,比较三组的流产率、早产率、剖宫产率、分娩孕周、新生儿出生体重、低出生体重儿等情况。结果减为单胎组早期流产率、早产率、剖宫产率、低体重儿发生率均低于减为双胎组(P<0.05);未减单胎组早产率、剖宫产率、低体重儿发生率均低于减为单胎组(P<0.05)。结论对于辅助生殖助孕的高龄不孕患者或多胎妊娠在早孕期行减胎术可以有效降低早产率、剖宫产率,延长分娩孕周,降低低出生体重儿等风险。Objective To investigate the pregnancy outcomes of multiple pregnancies after assisted reproduction in elderly infertile patients,and analyze its necessity and safety.Methods A retrospective analysis of 191 cases of infertility patients≥35 years old who underwent assisted reproductive technology(ART)to obtain the clinical data of multiple pregnancy reduction,110 cases of which were in the group of keeping single birth after reduction to single birth(including 2 cases of four birth reduction to single birth,21 cases of three birth reduction to single birth,87 cases of twin birth reduction to single birth).81 cases were in the reduced twins group(including 1 case of four reduced twins and 80 cases of three reduced twins).In addition,454 cases of ART singleton pregnancies aged≥35 years in the same period were randomly selected as the unreduced singleton group,and the abortion rate,premature delivery rate,cesarean section rate,gestational week of delivery,newborn birth weight,low birth weight infants and other conditions of the three groups were compared.Results The early abortion rate,premature birth rate,cesarean section rate and low birth weight rate in single group were lower than those in twin group(P<0.05).The preterm birth rate,cesarean section rate and incidence of low birth weight infants in the unreduced single group were lower than those in the reduced single group(P<0.05).Conclusion For elderly infertile patients with multiple pregnancies through assisted reproduction,fetal reduction in early pregnancy can effectively reduce the rate of premature delivery and cesarean section,prolong the gestational week of delivery,and reduce the risk of low birth weight infants.

关 键 词：多胎妊娠 高龄 辅助生殖技术 减胎术 妊娠结局 

分 类 号：R714.23[医药卫生—妇产科学]