超声引导下孕中期选择性多胎妊娠减胎术23例分析

目的 探讨超声引导下孕中期选择性多胎妊娠减胎术的临床应用价值。方法 超声引导下对23例孕中期多胎妊娠进行选择性减胎术，其中多胎妊娠中异常胎儿减胎7例，要求减少胎儿数目16例。结果 对23例孕妇施行减胎术共26例次，一次减胎成功率96．2％（25／26），再次减胎矫正后成功率100％。共手术减灭胎儿25个（2例四胎妊娠同时减去2个胎儿）。23例全部分娩。其中〉36周分娩者12例，32-36周7例，28-32周2例，〈28周2例（流产）。在23例分娩的孕妇中20例获存活健康新生儿32名，妊娠成功率86．96％。结论 超声引导下孕中期选择性多胎妊娠减胎术是一种方法简单、定位准确、安全可靠、有效的微创操作技术，为多胎妊娠的管理提供了一个新的方法。

Ultrasound-guided selective multifetal pregnancy reduction in second trimester:23 cases report

Objective To investigate the clinical application value of ultrasound-guided selective multifetal pregnancy reduction in second trimester.Methods Trans-abdominal selective pregnancy reduction in 23 multiple pregnancies were performed under ultrasound.Seven cases were performed for abnormal fetuses,and 16 cases for reducing fetal number.Results Twenty-six times of trans-abdominal selective pregnancy reduction in 23 multiple pregnancies were performed under ultrasound.The one action successful rate was 96.2%(25/26),the corrective successful rate for the second action was 100%.Twenty-five fetuses were reduced in total(two cases of quadruplet pregnancies reduced to twin pregnancies in one time).All cases had delivered:12 delivered after 36 weeks,seven delivered between 32 and 36 weeks,two delivered between 28 and 32 weeks and two aborted.All of the 32 newborns were normal.The successful pregnancy rate was 86.96%.Conclusions Ultrasound-guided selective multifetal pregnancy reduction in second trimester is an easy,safe,effective micro-invasive technique.It has provided a new method in treatment of multifetal pregnancy.