选择性减胎术在中期妊娠的应用  

Selective pregnancy reduction in second trimester

作　　者：游泽山[1] 方群[1] 陈健生[1] 黄珈[1] 

机构地区：[1]中山大学第一附属医院妇产科,广州510080

出　　处：《中华围产医学杂志》2004年第2期89-91,共3页Chinese Journal of Perinatal Medicine

摘　　要：目的　探讨选择性减胎术在中期妊娠的应用及其注意事项。　方法　对 19例多胎妊娠孕妇在妊娠 12～ 2 5周行选择性减胎术。其中双胎 6例 ,三胎 11例 ,四胎、六胎各 1例。在超声引导下经腹向胎儿心内或胸腔内注入高浓度的氯化钾。　结果　 6例双胎除 1例单绒毛膜双胎外均获减胎成功 ;11例三胎 ,除 1例减胎后计划生育引产 ,1例单卵三胎外 ,9例中 7例减胎成功 ,2例减胎后流产 ;1例四胎减胎成功 ;1例六胎减胎后流产。　结论　选择性减胎术可成功应用于妊娠中期 ,母亲无严重的并发症 ,但有一定的流产率。如果减胎术前能排除单卵双胎或单卵三胎 ,或能选择近宫底的妊娠囊进行减胎 ,或能将被减胎儿的羊水抽尽 ,或推迟减胎的时间 ,可能会降低流产率。Objective To investigate selective pregnancy reduction in second-trimester and its notices. Methods Selective pregnancy reduction in 19 cases of multiple pregnancy during 12～25 gestational age was performed,including 6 cases of twins,1 cases of triplets,1 case of quadruplet and 1 case of sextuplet. Ultrasonographically guided transabdominal intracardiac injection of high concentrate potassium chloride (KCl) solution was used. Results Performances of selective feticide in all twins were successful,except one monochorionic twins. In 11 cases of triplets,one case was aborted,one case was monozygotic triplet. Selective feticide was performed successfully in 7 of the rest 9 cases and the quadruplet Two cases were aborted after the procedure. The sextuplet was aborted after feticide. Conclusion Multifetal pregnancy reduction can be successfully performed in the second trimester without severe maternal complications. But abortion might occur afterwards. It is possible to reduce the abortion rate if monozygotic twin or triplet can be excluded before feticide,choosing the gestational sac which near the fundus,reducing the amniotic fluid volume of the target fetus or postponing feticide.

关 键 词：选择性减胎术 中期妊娠 多胎妊娠 产前诊断 

分 类 号：R714.23[医药卫生—妇产科学]