关于双绒毛膜双羊膜囊双胎妊娠第二胎儿延迟分娩的临床研究  

Clinical study on delayed delivery of the second fetus in dichorionic diamniotic twin pregnancy

作　　者：柯彩萍[1] 林丽萍 王晓怡[1] 李虹晔 陈敦金[1] Caiping Ke;Liping Lin;Xiaoyi Wang;Hongye Li;Dunjin Chen(Department of Obstetrics and Gynecology,The Third Affiliated Hospital,Guangzhou Medical University,Guangdong Provincial Key Laboratory of Major Obstetric Diseases,Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology,Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine,Guangzhou 510150,China)

机构地区：[1]广州医科大学附属第三医院妇产科,广东省产科重大疾病重点实验室,广东省妇产疾病临床医学研究中心,粤港澳母胎医学高校联合实验室,510150

出　　处：《中华产科急救电子杂志》2024年第3期159-167,共9页Chinese Journal of Obstetric Emergency（Electronic Edition）

基　　金：广东省卫生健康适宜技术推广项目(2022203);广州市卫生健康科技项目一般引导项目(20241A011089)。

摘　　要：目的探讨双胎妊娠第2胎儿延迟分娩的临床处理和预后。方法对我院收治的1例双绒毛膜双羊膜囊双胎妊娠第1胎儿流产后第2胎儿继续妊娠至足月分娩,及文献检索的25例双胎妊娠延迟分娩患者(共26例)的临床管理和预后进行分析。结果本例患者第1胎儿21^(+5)周流产后,经抗感染、抑制宫缩、监护等处理,第2胎儿继续妊娠至38^(+6)周阴道分娩,延迟分娩120 d,母儿预后良好;26例患者延迟分娩时间最短5 h,最长157 d,第1胎儿流产或早产孕周为14^(+4)~31^(+1)周,第2胎儿的分娩孕周为24~39^(+5)周,存活率约92.3%,大部分围产结局良好。结论延迟分娩处理得当可明显改善第2胎儿的围产结局,已成为双胎妊娠中一胎流产或早产后处理的重要措施。Objective To investigate the clinical management and prognosis of delayed delivery of the second fetus in twin pregnancy.Methods The clinical management and prognosis of 1 case of dichorionic diamniotic twin pregnancy who continued pregnancy to term delivery after the first fetus was aborted in our hospital and 25 cases of delayed delivery of twin pregnancies(26 cases in total)were analyzed in the literature search.Results In this case,after the abortion of the first fetus at 21+5 weeks,the second fetus continued to be pregnant for 38+6 weeks through anti-infection,inhibition of contractions,monitoring,and other treatment,and the delivery was delayed for 120 days.The prognosis of mother and child was good.A literature search of 26 cases of delayed delivery of twins showed that the shortest delivery time was 5 h and the longest was 157 d.The delivery gestational week of the first fetus was 14+4~31+1 weeks,and the delivery gestational week of the second fetus was 24~39+5 weeks.The survival rate was about 92.3%.Most perinatal outcomes were good.Conclusions Proper management of delayed delivery can significantly improve the perinatal outcome of the second fetus and has become an important measure to deal with the abortion or premature delivery of one of the twins.

关 键 词：妊娠 双胎 分娩 时间 疾病管理 预后 

分 类 号：R714.2[医药卫生—妇产科学]