辅助生殖技术与自然受孕双胎妊娠结局临床分析

目的探讨辅助生殖技术受孕双胎妊娠与自然受孕双胎妊娠围生期的结局。方法回顾分析288例双胎妊娠孕妇，其中121例辅助生殖技术受孕双胎妊娠孕妇为研究组，同期自然受孕双胎孕妇167例为对照组，记录、比较两组并发症、分娩方式及围产儿结局等情况。结果研究组孕妇平均年龄高于对照组（30．31±3．329）岁vs（28．93±4．641）岁]，分娩孕周早于对照组（35．2±4．37）周vs（36．2±3．02）周]，顺产率明显低于对照组（2．48％vs11．38％），差异均有统计学意义（P〈0．05）。研究组的胎膜早破、妊娠期高血压疾病、妊娠期贫血发生率、新生儿窒息率明显低于对照组，差异均有统计学意义（P〈0．05）。研究组晚期流产、妊娠期糖尿病、羊水过多等发生率高于对照组，但差异无统计学意义（P〉0．05）。研究组新生儿平均体重、双胎之一胎死宫内及胎儿畸形率与对照组比较，差异无统计学意义（P〉0．05）。结论辅助生殖技术受孕双胎与自然受孕双胎相比，胎膜早破、妊娠期高血压疾病及贫血发生率低，而晚期流产、妊娠期糖尿病及羊水过多发生率相对偏高，且分娩孕周早。故应加强其孕中期宫颈长度检测及早产预测，必要时行宫颈环扎术，降低晚期流产及早产率，并加强妊娠期血糖监测及膳食管理，降低妊娠期糖尿病发生率。

Pregnancy outcome of twin pregnancies conceived by assisted reproductive technique and those conceived spontaneously

Objective To compare the pregnancy outcome of twin pregnancies conceived by assisted reproductive technique （ART） and those conceived spontaneously. Methods The complications, mode of delivery and pregnancy outcome of 121 twin pregnancies conceived by ART （study group） and 167 spontaneous twin pregnancies （control group） were analyzed retrospectively. Results Older mean age, shorter gestational weeks were found in the study group than those in the control group （30.31±3.329 vs 28.93±4.641 years old , 35.2±4.37 vs 36.2±3.02 gestational weeks）. The rate of vaginal delivery in the control group （2.48%） was lower than that in the study group （11.38%）. The differences between the two groups were significant （P〈0.05）. Lower incidence of premature rupture of membrane, hypohemia and pregnancy hypertension were found in the study group than those in the control group, the differences between the two groups were significant （P〈0.01）. Significantly lower incidence of neonatal asphyxia was seen in the study group than those in the control group （P〈0.05）. Incidence of late spontaneous abortion, GDM and polyhydramnios of the two groups show no significant differences （P〉0.05）. There were no significant differences in the neonatal average weight, the incidence of one fetus intrauterine demise and the fetal malformation rate between the two groups. Conclusion When compared with spontaneously conceived twin pregnancies, those conceived by ART are more likely to have different complications and neonatal outcome. It is important to have a close monitoring during antepartum and intrapartum period, so as to have a better pregnancy outcome of twin pregnancy conceived by ART.