体外受精/卵胞质内单精子显微注射双卵双胎减胎后妊娠结局的病例对照研究

目的探讨双卵双胎妊娠早期减胎为单胎的妊娠结局。方法 2008年1月—2014年12月期间体外受精及卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)后双胎妊娠早期(孕45~75 d)减胎为单胎者102例(A组),三胎妊娠早期减胎为双胎者73例(B组)以及双胎妊娠未减胎者4 638例(C组),比较其中晚期流产率、早产率等进一步的妊娠结局。结果 IVF/ICSI-ET后A组与B组和C组比较,早产率(10.8%,58.6%,42.1%)、低出生体质量儿率(6.8%,44.1%,30.3%)明显降低,孕周(38.0±2.0)周,(35.7±2.3)周,(36.4±2.1)周]、出生体质量(3.17±0.53)kg,(2.51±0.59)kg,(2.69±0.53)kg]明显增加,差异有统计学意义(P0.05),中晚期流产率差异无统计学意义(P0.05)。结论 IVF/ICSI后的双卵双胎妊娠,于孕早期行减胎术安全,具有更好的妊娠结局。

A case-control study on pregnancy outcome of fetal reduction to single fetus from dizygotic twins after in vitro fertilization and intracytoplasmic sperm injections

Objective To discuss the pregnancy outcomes ofreduction ofbiovular twin pregnancy.Methods The pregnancy outcomes including late abortion rate and premature delivery rate were compared among 102 cases of twin pregnancy underwent fetal reduction to singleton (group A),75 cases of triplet pregnancy underwent fetal reduction to twin pregnancy (group B) in the early trimester of pregnancy and 4 638 cases of twin pregnancy did not accept fetal reduction (group C) after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) from January 2008 to December 2014.Results The rate of premature,delivery with low birth weight children were reduced significantly,gestational weeks were longer and birth weight was increased significantly in the group of early fetal reduction of biovular twin pregnancy,compared with that in the group of triplet pregnancy reduced to twin pregnancy and the group of twin pregnancy without fetal reduction,and the differences were statistically significant (P＜0.0 5).The differences in the late abortion rate were not statistically significant.Conclusion For the biovular twin pregnancy,it was safe and got better pregnancy outcome to conduct fetal reduction in the early trimester.