肾上腺糖皮质激素对双胎围产儿预后的影响

目的 探讨肾上腺糖皮质激素对双胎妊娠围产儿的作用。方法 56例双胎妊娠孕妇根据是否应用糖皮质激素分成两组,实验组:18例,于分娩前1周到24小时之间曾应用糖皮质激素;对照组:38例,在该时间内未应用糖皮质激素。比较两组围产儿预后间的差别。结果 在分娩孕周≤34周时,实验组的新生儿呼吸窘迫症的发病率和围产儿死亡率明显低于对照组(P<0.05);在孕周>34周时,无一例发生新生儿呼吸窘迫症,围产儿死亡率在实验组反而高于对照组(P<0.05);新生儿窒息的发生率在两组之间无明显的差别。结论 双胎妊娠可能在34周或以前分娩者,肾上腺糖皮质激素可降低新生儿呼吸窘迫症的发生率和围产儿死亡率;在34周以后分娩者,肾上腺糖皮质激素对改善围产儿预后无效。

The effect of antenatal cortical hormone administration on the perinatal outcomes hi preterm twin pregnancy

Objective To study the effect of antenatal cortical hormone administration on the perinatal outcomes in preterm twin pregnancy. Methods 56 cases of twin pregnancy women were divided into two groups,test group: 18 pregnancy women,which had received cortical hormone during one week to 24 hours before delivery; control group: 38 case of twin pregnancy women without cortical hormone administration during that time. The perinatal outcomes were compared between these two groups. Results The incidence of neonatal respiratory distress syndrome (IVRDS) and perinatal mortality in twin pregnancy who delivered in or before 34 gestational weeks were less in test group than in control group ( P < 0.05) .No NRDS was found in twin pregnancies who deliv-eried after 34 gestational weeks. The perinatal mortality in twin pregnancies who deliveried after 34 gestational weeks in test group was significantly higher than that in control,(P <0.05) however there was no difference for NRDS in the two groups.Conclusions Antenatal steroid administration was effective on the perinatal outcomes in twin pregnancy who deliveried in and before 34 gestational weeks,and it was ineffective who deliveried after 34 gestational weeks.