超声引导下经阴道多胎妊娠减胎术后妊娠结局分析

目的 分析行多胎妊娠减胎术患者的妊娠结局情况。方法 回顾性分析2009年1月至2019年9月期间63例多胎妊娠孕妇在我院经阴道减胎术的临床资料,根据患者减胎类型不同将患者分为四组:四胎减为双胎组、三胎减为双胎组、三胎减为单胎组、双胎减为单胎组,分析各组患者减胎术后妊娠结局情况。结果 实行减胎术的63例患者中,有50例成功分娩,早期流产3例(4.67%),晚期流产9例(14.29%),因胎儿唇裂行引产术1例(1.59%),足月产37例(58.73),早产13例(20.63%),低体质量儿率43.53%。多胎减为双胎的两组间以及多胎减为单胎的两组间早期流产、早产、新生儿体重、低体质量儿率等差异无统计学意义。与多胎减为单胎组相比,多胎减为双胎组新生儿体质量低,P＜0.05,而两组间早期流产率、晚期流产率、早产率、低体质量儿率等均无统计学差异。结论 多胎妊娠减胎术后妊娠结局可能与最终妊娠数相关,而与最初妊囊数关系不大,多胎减至双胎组较多胎减为单胎组有较高的并发症发生,因此建议接受多胎妊娠减胎术的患者减至单胎妊娠。

Analysis of pregnancy outcome after multifetal pregnancy reduction under the guidance of transvaginal ultrasound

Objective To analyze the pregnancy outcome of patients undergoing multiple pregnancy reduction.Methods Retrospective analysis was carried out on clinical data of 63 pregnant women with multiple pregnancies through transvaginal fetal reduction. The patients were divided into four groups: four fetuses reduced to twins group, three fetuses reduced to twins group, three fetuses reduced to singles group, and twins reduced to singles group. The pregnancy outcome of patients in each group after pregnancy reduction was analyzed.Results Of the 63 patients undergoing fetal reduction, 50 had a successful delivery, 3 had early miscarriage (4.67%), 9 had late miscarriage (14.29%), 1 had induced labor due to fetal cleft lip, and 37 had full-term labor (58.73%), 13 cases of premature delivery (20.63%), and the rate of low birth weight infants was 43.53%. There was no statistically significant difference between the two groups reduced to twins and the two groups reduced to singles in early abortion, premature delivery, neonatal weight, and low-birth-weight infants. Compared with the multiple fetuses reduced to singles, the multiple fetuses reduced to twins groups had lower birth weight, and the difference was statistically significant. There was no statistical difference between the groups in the early abortion rate, late miscarriage rate, premature birth rate, and low birth weight rate.Conclusion Pregnancy outcomes after multiple pregnancy reduction are mostly related to the final number of pregnancy, but not related to the number of initial pregnancy sacs. The multiple fetuses reduced to twins groups have higher complications than reduction to singles, so it is recommended that multiple pregnancy reduction be better to single pregnancy