不同妊娠方式所致双胎母婴并发症的临床分析

目的探讨双胎试管和双胎自然受孕母婴并发症的差异,为指导临床处理提供参考。方法收集本院2010年1月-2013年12月双胎试管婴儿110例(试管组),双胎自然受孕婴儿86例(自然受孕组),比较两组母亲一般情况、分娩情况、妊娠并发症和新生儿一般情况、并发症和治疗情况等方面的差异。结果 1)试管婴儿组母亲年龄明显大于自然受孕组(P0.001),前者孕周亦明显小于后者(P0.001),其他比较差异无统计学意义(P0.05)。2)母亲妊娠并发症中,本研究发现8种并发症,其中易栓症、妊娠期高血压为试管婴儿组高于自然受孕组(P0.05),妊娠期糖尿病为自然受孕组高于试管婴儿组(P0.05),先兆早产和胎膜早破在两组中差异无统计学意义(P0.05)。3)试管婴儿组新生儿出生体重小于自然受孕组(P0.05),其他比较差异无统计学意义(P0.05)。4)新生儿并发症方面,本研究发现20种并发症,结果仅有早产儿脑损伤为试管婴儿组高于自然受孕组(P0.05),其余差异无统计学意义(P0.05)。结论双胎试管婴儿组母亲年龄较大,孕周较小,更容易发生易栓症和妊娠期高血压,双胎试管婴儿出生体重偏小,其早产儿脑损伤发生率高;双胎自然受孕母亲妊娠期糖尿病发生率较高。不同妊娠方式所致双胎母婴并发症数目上没有明显差异。

Clinical analysis of maternal and neonatal complications caused by different ways of twins pregnancy

Objective To investigate the difference of the maternal and neonatal complications between twins in vitro fertilization (IVF) and twins conceived naturally. Methods From January 2010 to December 2013, 110 cases twins IVF babies(IVF group), and 86 cases twins conceived naturally infants (conceived naturally group) were collected, and compared the general situation, delivery situation, the pregnancy complications of two groups mothers and the general situation, complications, treatment of neonatal were compared. Results 1) The mother's age of IVF group was older than conceived naturally group (P<0.001), the former's gestational age was much younger than the latter (P<0.001), and others had no statistical significance (P>0.05).2)In mother's pregnancy complications, this study found eight kinds of complications, thrombophilia and gestational hypertension of IVF group were higher than conceived naturally group (P<0.05), gestational diabetes mellitus(GDM) of conceived naturally group was higher than IVF group (P<0.05), the threatened premature labor and the premature rupture of membrane had no obvious differences in these two groups (P>0.05).3)The newborn birth weight of IVF group was less than conceived naturally group (P<0.05), and others had no statistical significance (P>0.05).4)In neonatal complications, this study found 20 kinds of complications.It found only premature infant brain injury of IVF group was higher than conceived naturally group (P<0.05), and other diseases had no difference(P>0.05). Conclusions The twins' mother of IVF group is older, smaller gestational age, and more likely to happen thrombophilia and high blood pressure during pregnancy, IVF baby has small born weight, and high incidence of premature infant brain injury;the twins' mother of conceived naturally has a greater incidence of gestational diabetes mellitus.The number of maternal and neonatal complications caused by different ways of twins pregnancy have no significant difference.