双胎妊娠围生期处理与围生儿分析

目的探讨双胎妊娠的围生期处理及影响妊娠结局的因素，为双胎妊娠的围生保健和并发症的防治提供参考。方法回顾性分析在我院住院分娩的99例双胎妊娠产妇的临床资料。结果双胎妊娠并发症发生率高，早产49．5％，妊娠期高血压疾病28．3％，贫血19．2％，胎膜早破25．3％。新生儿窒息率和围生儿死亡率随着双胎妊娠孕周的增加而下降，早产组与足月妊娠组比较，差异有统计学意义（P〈0．05）。阴道分娩组及阴道助产组新生儿窒息率明显高于剖宫产组，差异有统计学意义（P〈0．05）。阴道分娩组及阴道助产组围生儿死亡率也明显高于剖宫产组。分娩孕周及出生体重是影响围生儿预后的主要因素。结论双胎妊娠并发症、合并症发生率及围生儿死亡率均较高，早产及妊娠期高血压疾病是主要并发症。为降低新生儿窒息率和围生儿死亡率，应加强围生期保健，积极防治并发症，尽量延长孕周，选择适当的分娩时机和分娩方式，且适当放宽剖宫产指征。

Study on the Perinatal Treatment and the Perinatal in Twin Pregnancy

Objective To study the clinical features of twin pregnancy and the factors which influence the pregnancy outcomes for improve perinatal care and complication treatment of twin pregnancy.Methods 99 cases of twin pregnancy in our hospital were studied retrospectively.Results The incidence of pregnancy complications were higher in twin pregnancy than average:The prevalence of preterm labor was 49.5%,pregnancy induced hypertension synodome was 28.3%,anemia was 19.2%,rupture of memberane was 25.3%.The neonatal asphyxia and perinatal mortality in premature delivery were significantly higher than that of mature delivery(P<0.05).The neonatal asphyxia in vaginal delivery and vagina midwifery were significantly higher than that of the cesarean section(P<0.05).The perinatal mortality in vaginal delivery and vagina midwifery were higher than that of the cesarean section.The gestational age and birth weight were the major factors influencing the perinatal outcome.Conclusions The incidence of pregnancy complications and perinatal mortality were higher in twin pregnancy than average;Premature delivery and pregnancy induced hypertension synodome were the main complications.Regular perinatal care,prevention and cure complications,avoidance of premature birth,and proper choice for the time and mode of delivery are important measures to decrease the perinatal mortality and morbidity of twin gestations.