体外受精-胚胎移植后三胎妊娠减胎术后随访结局分析

目的探讨体外受精-胚胎移植（IVF-ET）技术中减胎技术对于妊娠结局的影响。方法回顾性分析2005.01-2008.06期间于我中心接受IVF-ET治疗后三胎妊娠减为双胎妊娠33例（A组）及同期治疗获双胎妊娠69例（B组）随访资料,比较两组的流产率、早产率及新生儿出生胎龄、体重、围生儿死亡率等。结果流产率A组27.3%,B组15.9%;平均出生胎龄A组（36.4±2.4）周,B组（36.4±2.8）周;围生儿死亡率A组8.3%,B组6.0%,两组比较差异无显著性（P〉0.05）。早产率A组29.2%,B组25.9%,两组比较差异有显著性（P〈0.05）;平均出生体重A组（2386±602）g,明显低于B组（2586±595）g（P〈0.05）;出生体重〈1500g的比例A组10.4%,B组8.6%,两组比较差异有显著性（P〈0.05）。结论三胎妊娠早期行减胎术存在早产及低出生体重儿出生的可能性,选择适宜的移植胚胎数目,减少多胎妊娠的发生,才是预防不良妊娠结局的有效途径。

The outcome of follow-up after selective reduction of triplet pregnancy after in vitro fertilization-embryo transfer

Objective：To evaluate the influences of the pregnancy outcome of multifetal pregnancy reduction.Methods：Reviewing analyze the follow-up data of the 33 cases（Group A）who received IVF-ET treatments and then reduced trial-pregnancy to double-pregnancy in our center between 2005.01 and 2008.06,whereas the data of 69 cases（Group B）who accepted the therapies and reached double-pregnancy in the same time.To compare the abortion rate,the premature delivery rate,the birth gestational age,weight,the perinatal death rate of the neonatal between the groups.Results：The abortion rate is 27.3% for A and 15.9% for B;the mean birth gestational age is（36.4±2.4）weeks for A and（36.4±2.8）weeks for B;the perinatal death rate is 8.3% for A and 6.0% for B,there is no significant difference between two groups（P〉0.05）.The premature delivery rate is 29.2% for A and 25.9% for B,the difference is comparable between the groups（P〈0.05）.The mean birth weight（2386±602）g for A is obviously lower than（2586±595）g for B（P〈0.05）;the percentage of birth weight 〈1500g for A is 10.4% and 8.6% for B.There is a significant difference between the groups（P〈0.05）.Conclusion：There is a possibility of having premature delivery and low birth weight as reduction of early trial-pregnancy.To choose the appropriate number of embryos resulting in reducing the occurrences of multiple pregnancy is an effective way to prevent the consequences of adverse pregnancies.